Multifocal primary hepatic epithelioid hemangioendothelioma: a case in which tumor biopsy was critical to prevent misdiagnosis.
Yuya Matsuo, Keisuke Nakanishi, Shinsaku Nagamatsu et al.
✦ AI-curated · Sources linked
Case in brief
An 82-year-old woman undergoing postoperative surveillance for bladder cancer was found to have multiple hepatic masses on contrast-enhanced CT. Because bladder cancer had also recurred locally, the liver lesions were suspected to be metastases. Immunohistopathological assessment of a liver biopsy excluded metastatic carcinoma and established primary hepatic epithelioid hemangioendothelioma. The patient subsequently died of liver failure.
What made this case unusual
Concurrent local bladder cancer recurrence made metastatic disease a compelling interpretation of the multiple liver lesions, but biopsy revealed a separate primary hepatic tumor.
Diagnostic / clinical pearl
Multiple liver lesions in a patient with a known malignancy should not automatically be attributed to metastases; biopsy and immunohistopathological evaluation may be essential when imaging is nonspecific.