特異な画像所見を呈した肝類上皮性血管内皮腫の1切除例

大隈 和英; 位藤 俊一; 森口 聡; 森島 宏隆; 藤井 仁; 栗田 晃宏; 藪内 以和夫; 有馬 良一; 松田 康雄

doi:10.2957/kanzo.48.290

Case Reports

A case of epithelioid hemangioendothelioma of the liver with unique radiological findings

Kazuhide Okuma, Toshikazu Ito, Akira Moriguchi, Hirotaka Morishima, Hitoshi Fujii, Akihiro Kurita, Iwao Yabuuchi, Ryouichi Arima, Yasuo Matsuda

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Keywords: epithelioid hemangioendothelioma of the liver, contrast enhancement ultrasonography, liver tumor

JOURNAL FREE ACCESS

2007 Volume 48 Issue 6 Pages 290-295

DOI https://doi.org/10.2957/kanzo.48.290

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Abstract

A 79 years old male was notified of a liver tumor at a medical checkup in April 2002: the tumor was visualized by ultrasonography as a hyper-isoechoic lesion with hypo-echoic rim. Ultrasonic contrast enhancement employing Levovist^TM revealed that the tumor was penetrated by Glisson's capsule, with a characteristic fish eye image of the tumor in portal phase. SPIO-MRI of T2-weighted imaging visualized the tumor as a three-layer structure with concentric circles. Without definite preoperative diagnosis, the patient underwent hepatic S6-subsegmentectomy in July 2002. The tumor, 2.8 cm × 2.5 cm in size, was diagnosed ultimately as an epithelioid hemangioendothelioma (EHE) based on positive immunohistological results with antibodies against CD34, Factor VIII, etc. Since hepatic EHE is rare by itself, let alone for the precise analyses of preoperative image-diagnosis findings in comparison with postoperative histological findings, here we report our own case in discussion with those in literatures.

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