Hepatic epithelioid hemangioendothelioma after thirteen years’ follow-up: A case report and review of literature

Figure 1 Contrast-enhanced computed tomography. Multiple low-density lesions (black arrow) with mild-moderate peripheral enhancement are seen in the right lobe of the liver.

Figure 2 Magnetic resonance weighted image. A: T1-weighted image shows low signal ovoid lesions in the right lobe of liver; B: The lesions have a heterogeneous high signal in the T2-weighted image; C: The largest lesion in the right lobe is mildly heterogeneous with peripheral enhancement and an arterial contrast enhancement pattern; D: Peripheral enhancement of lesions is increased in spots visible in a venous contrast enhancement pattern; E: Lesions show diffusion restriction on a diffusion-weighted image.

Figure 3 Liver biopsy. A: Mildly heteromorphic spindle cells (dendritic cells) with interdigitating processes (hematoxylin and eosin, 200 ×); B: Intracellular vascular lumina containing a red blood cell (black arrow) (hematoxylin and eosin, 400 ×).

Figure 4 Histopathology, immunostaining of tumor cells. A: Anti-CD31+ (200 ×); B: Anti-CD34+ (200 ×); C: Anti-factor VIII-related antigen+ (200 ×); D: Anti-CK− (Pan) (200 ×).

Figure 5 Contrast-enhanced follow-up computed tomography scans. A: After 4 years, diameter of the low-density lesion was 16 mm; B: After 12 years, diameter of the low-density lesion was 17 mm.