Hepatic small vessel neoplasm case report: A surveillance conundrum

Introduction: Hepatic small vessel neoplasm (HSVN) is a recently described vascular neoplasm of the liver that can mimic hepatic angiosarcoma (AS) because of its infiltrative nature but is considered benign or, at most, low-grade. HSVN appears to demonstrate a benign clinical course with no reported recurrences or metastatic disease, although its long-term malignant potential is uncertain.

Case presentation: We present a 57-year-old man with an incidentally growing segment VII lesion that displayed features concerning for a neoplasm. He underwent a posterior sectionectomy and final histopathology confirmed a 27 mm HSVN. As the long-term malignant potential of HSVN is uncertain, he will be followed up with serial MRI scans over the next 5 years.

Discussion: HSVN is a recently described entity, it is uncertain what the long-term malignant potential of HSVN can be. Reported cases have not shown any evidence of disease progression.

Conclusion: There are no clear guidelines established on the duration of the follow-up of HSVN. More research needs to be done to determine further the natural history of these tumours and possible radiological criteria.