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A case of a resectable single hepatic epithelioid hemangioendothelioma with characteristic imaging by ADC map

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Abstract

A 47-year-old woman with a single-nodule hepatic tumor was referred to our hospital. She had no symptoms. The tumor was located at the surface of the right lobe of the liver; it showed peripheral low signal intensity on a magnetic resonance imaging apparent diffusion coefficient (ADC) map, and an influx of blood flow into the peripheral area of the tumor at the early vascular phase on perflubutane microbubble (Sonazoid®) contrast-enhanced (CE) ultrasonography. Since we suspected a malignant tumor, the patient underwent surgical resection. The hepatic tumor was resected curatively. Pathological examination revealed that the tumor was composed of epithelioid cells with an epithelioid structure and/or cord-like structure. Immunohistochemical staining was positive for cluster of differentiation 34 and factor VIII-related antigen. Based on the above, a final diagnosis of hepatic epithelioid hemangioendothelioma (EHE) was made. Hepatic EHE is a rare hepatic tumor: only a few cases of hepatic EHE with curative resection have been reported. We were unable to reach a diagnosis of hepatic EHE by imaging studies; however, an ADC map was useful in showing the malignant potential of the tumor, and CE ultrasonography was useful in revealing the peripheral blood flow of the tumor. When an unusual hepatic mass is encountered, hepatic EHE should be kept in mind, and the mass should be inspected with more than one imaging modality, including an ADC map, in the process of differential diagnosis.

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Authors and Affiliations

  1. Department of Gastroenterology, Suzuka General Hospital, 1275-53 Yasuduka-cho, Suzuka, Mie, 513-8630, Japan

    Hiroshi Okano, Hideki Nakajima, Tomomasa Tochio, Daisuke Suga, Hiroaki Kumazawa, Yoshiaki Isono, Hiroki Tanaka, Shimpei Matsusaki, Tomohiro Sase, Tomonori Saito, Katsumi Mukai & Akira Nishimura

  2. Department of Radiology, Suzuka General Hospital, 1275-53 Yasuduka-cho, Suzuka, Mie, 513-8630, Japan

    Nobuyoshi Matsushima

  3. Department of Pathology, Suzuka General Hospital, 1275-53 Yasuduka-cho, Suzuka, Mie, 513-8630, Japan

    Youichirou Baba & Tetsuya Murata

  4. Department of Surgery, Suzuka General Hospital, 1275-53 Yasuduka-cho, Suzuka, Mie, 513-8630, Japan

    Takashi Hamada & Hiroki Taoka

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  1. Hiroshi Okano
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  2. Hideki Nakajima
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  16. Takashi Hamada
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  17. Hiroki Taoka
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Corresponding author

Correspondence to Hiroshi Okano.

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Conflict of interest

Hiroshi Okano, Hideki Nakajima, Tomomasa Tochio, Daisuke Suga, Hiroaki Kumazawa, Yoshiaki Isono, Hiroki Tanaka, Shimpei Matsusaki, Tomohiro Sase, Tomonori Saito, Katsumi Mukai, Akira Nishimura, Nobuyoshi Matsushima, Youichirou Baba, Tetsuya Murata, Takashi Hamada and Horoki Taoka have no conflict of interest.

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Okano, H., Nakajima, H., Tochio, T. et al. A case of a resectable single hepatic epithelioid hemangioendothelioma with characteristic imaging by ADC map. Clin J Gastroenterol 8, 406–413 (2015). https://doi.org/10.1007/s12328-015-0604-9

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  • DOI: https://doi.org/10.1007/s12328-015-0604-9

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