Hepatic epithelioid hemangioendothelioma: A great mimicker

Int J Surg Case Rep. 2018:53:25-28. doi: 10.1016/j.ijscr.2018.10.013. Epub 2018 Oct 12.

Abstract

Introduction: Epithelioid hemangioendothelioma is a malignant mesenchymal tumor of unknown etiology. They tend to be asymptomatic or with non-specific symptoms. The lesion is usually multiple and variable size.

Presentation of case: We describe a clinical case of a 23-years-old patient diagnosed with a pelvic mass, a possible uterine fibroid or adnexal mass, and multiple liver lesions that seemed an advanced ovarian cancer presentation and after liver biopsy turned out to be a hepatic epithelioid hemangioendothelioma.

Discussion: It may be confused with a metastatic process in diagnostic imaging. There have been described some possible risk factors but the etiology remains unknown. The prognosis is usually lethal in 50% of cases. The surgical removal of the lesion and liver transplant appear to be the only hope for these patients.

Conclusion: Epithelioid hemangioendothelioma must be part of our differential diagnosis when we find a liver tumour, especially in young women. Treatment is excision of the tumour in limited disease. In the case of unresectable disease are candidates for liver transplantation.

Keywords: Adnexal mass; Advanced ovarian cancer; Epithelioid hemangioendothelioma; Fibroid; Hepatic lesion; Liver.