IS case 545: Epithelioid hemangioendothelioma

Nate Johnson, MD

University of Rochester

Imaging Sciences URMC 2010
Publication Date: 2010-09-18

History

Patient is a 18-year-old female referred from outside institution for liver transplant post biopsy proven epithelioid hemangioendothelioma.

Findings

Large, predominately low attenuation, lesion along the periphery of the liver with capsular retraction.

Discussion

Typical Presentation:

1. Middle aged patient (average age 45 y/o) 2. Abdominal pain, jaundice, hepatomegaly (rarely asymptomatic) 3. Hemoperitoneum, Budd-Chiari or liver failure (more rarely)

Other Clinical Issues:

1. Typical survival 5-10 years 2. Treatment = radical resection or transplant

Appearance:

1. Peripheral lesion with extension to capsule 2. Capsular retraction 3. Coalescent nodules (most common) at periphery vs, confluent mass 4. Target shaped enhancement post contrast (non-enhancing center with inner enhancing rim and outer non-enhancing rim) 5. Almost 1/2 have metastases

References

  1. Federle M, Jeffrey RB, Woodward P, Borhani AA. Diagnostic Imaging: Abdomen, 2nd ed. Amirsys, 2009.

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