Diagnostic challenges and radiological insights of rare hepatic perivascular epithelioid cell tumor: A case report and review of the literature

Figure 1 Images of the first contrast-enhanced computed tomography. A: The lesion demonstrated significant enhancement in the arterial phase; B and C: Slightly higher enhancement in the portal vein and delayed phases compared to the hepatic parenchyma.

Figure 2 Images of the second contrast-enhanced computed tomography. A: During the arterial phase, the lesion demonstrated heterogeneous enhancement, while the contrast agent was being washed out during the portal vein phase and delayed phase; B and C: Patchy low-density shadows.

Figure 3 Enhancement patterns of contrast-enhanced ultrasound. A: The lesion demonstrated a marked enhancement in the arterial phase; B: The lesion began to wash out during the portal vein phase; C: In the delayed phase, the lesion appeared slightly hypoechoic.

Figure 4 Postoperative pathological findings. A: Hematoxylin-eosin staining. The tumor cells are polygonal with translucent cytoplasm containing uneven eosinophilic granules. Perinuclear eosinophilic condensation shows a clear appearance (black arrow). The nuclei are round or oval with a distinct nucleolus and sparse chromatin (white arrow); B and C: Immunohistochemical staining revealed positivity for HMB45 (B) and Melan-A (C), with increased expression in both the cytoplasm and nuclei of tumor cells compared to normal liver cells.