Hepatic epithelioid hemangioendothelioma in a young female mimicking metastasis on radiology: Report of a case with brief review of literature

Hepatic epithelioid hemangioendothelioma, is a rare vascular tumor of undetermined malignant potential. Clinical symptoms and signs are nonspecific, and the diagnosis may be easily missed. We report a case of 23‑year‑old female who presented with right upper quadrant abdominal pain. Ultrasonography of the abdomen showed multiple discrete nodules in the liver with complex architecture and a hypo echoic centre. Contrast enhanced computed tomography was also performed, which showed peripheral rim enhancement in the arterial phase and “target‑sign” in portal and venous phases. These radiological findings suggested metastasis on radiology. However, serum alpha‑fetoprotein, CA‑125 and carcinoembryonic antigen were within the normal limits. A tru‑cut biopsy from the liver nodule showed the presence of tumor cells invading the liver, which was suggestive of epithelioid hemangioendothelioma and later confirmed by CD34 and CD31 immunostains. The patient, presently on thalidomide treatment regimen, is surviving with a stable disease.