Journal of Shandong University (Health Sciences) ›› 2022, Vol. 60 ›› Issue (11): 89-95.doi: 10.6040/j.issn.1671-7554.0.2022.0572

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Hepatic epithelioid hemangioendothelioma complicated with hepatitis B cirrhosis: a case report and literature review

LI Xiangze1,2, WANG Xianming2, SONG Gesheng3, CUI Jing4, SUN Kai2, WANG Haochen2, WANG Tiancheng2, HAN Shaoqi2, TIAN Hu1,2   

  1. 1. Department of General Surgery, Shandong Provincial Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250014, Shandong, China;
    2. Department of General Surgery, The First Affiliated Hospital of Shandong First Medical University &
    Shandong Provincial Qianfoshan Hospital, Jinan 250014, Shandong, China;
    3. Department of Radiology, The First Affiliated Hospital of Shandong First Medical University &
    Shandong Provincial Qianfoshan Hospital, Jinan 250014, Shandong, China;
    4. Department of Pathology, The First Affiliated Hospital of Shandong First Medical University &
    Shandong Provincial Qianfoshan Hospital, Jinan 250014, Shandong, China
  • Online:2022-11-10 Published:2022-11-04

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Abstract: Objective To analyze the clinical and imaging characteristics of a patient with hepatic epithelioid hemangioendothelioma misdiagnosed preoperatively as hepatocellular carcinoma complicated with hepatitis B cirrhosis, so as to improve the understanding of this disease, reduce misdiagnosis and guide clinical diagnosis and treatment. Methods The clinical data of the patient were collected and analyzed, relevant case reports were retrieved and literature review was reviewed. Results The patient, a 51-year-old male, was admitted due to “isolated liver space-occupying lesions found in physical examination for more than 3 days”, and no other special abnormalities were obsevred. There were no obvious abnormalities in tumor markers. MRI of liver showed that plain scan was not characteristic. DWI and ADC suggested limited diffusion at the edge of the lesion, and unrestricted diffusion at the central area, suggesting combined necrosis. Enhanced scanning showed similar results, presenting uneven peripheral enhancement, which tended to invade inwards and clear during the delay period. Postoperative pathology confirmed hepatic epithelioid hemangioendothelioma. Conclusion In clinical diagnosis and treatment, the possibility of liver solid space-occupying lesions should be considered when there are no typical manifestations of common diseases such as hepatocellular carcinoma, cholangiocarcinoma and hepatic hemangioma, especially when imaging suggests typical “capsule retraction sign”, “target sign” or “lollipop sign”.

Key words: Hepatic epithelioid hemangioendothelioma, Hepatitis B cirrhosis, Imaging findings, Differential diagnosis

CLC Number: 

  • R735.7
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