Beyond rare: a case of hepatic epithelioid hemangioendothelioma with atypical imaging features

Abstract

Epithelioid hemangioendothelioma (EHE) is a rare vascular tumor that can affect various organs. This report describes a 65-year-old woman who presented with abdominal pain, weight loss, and elevated liver enzymes. After the diagnostic workup, a percutaneous biopsy of the liver lesions showed histological changes in EHE. What stands out in this case is that imaging studies revealed multiple cystic lesions with fluid-fluid levels; even though such manifestation is not typically seen in this disease. This case emphasizes the importance of considering EHE in the differential diagnosis of hepatic lesions even in atypical presentations.