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Malignant perivascular epithelioid cell tumor arising in the mesentery: A case report
Yinghong Shi1, Junzu Geng2, Haizhu Xie2
1Department of Radiology, Shandong Medical Imaging Research Institution, Shandong University, Jinan, Shandong 250021, P.R. China ; Department of Radiology, Yuhuangding Hospital, Yantai, Shandong 264000, P.R. China.
Abstract:
Primary perivascular epithelioid cell tumors (PEComas) of the mesentery are rare; therefore, the clinical and imaging features of the tumor have yet to be adequately investigated. The present study reports the case of a 48-year-old female patient histologically diagnosed with a PEComa arising in the mesentery of the small bowel. Abdominal plain computed tomography (CT) identified a large, partially ill-defined and heterogeneous mass with a size of 12.5×8.5-cm occupying the lower abdomen. Upon contrast-enhanced CT imaging, the tumor displayed nonhomogeneous contrast-enhancement with hypodense areas, and multiple tumor vessels were observed during arterial phase imaging. In conclusion, the present study proposed that PEComas should be considered in the differential diagnosis of lesions arising in the mesentery; however, differentiation based on imaging criteria alone can be difficult.
Insights
This study details a rare mesenteric perivascular epithelioid cell tumor (PEComa). Imaging revealed a large, heterogeneous mass, highlighting the diagnostic challenges of PEComas in the mesentery.
Area of Science:
- Oncology
- Radiology
- Gastroenterology
Background:
- Primary perivascular epithelioid cell tumors (PEComas) of the mesentery are exceptionally rare.
- Limited data exists on the clinical and imaging characteristics of these rare mesenteric tumors.
Purpose of the Study:
- To report a case of a primary mesenteric PEComa.
- To describe the computed tomography (CT) findings associated with this rare tumor.
Main Methods:
- A case report of a 48-year-old female patient with a mesenteric PEComa.
- Detailed analysis of abdominal plain and contrast-enhanced CT imaging features.
Main Results:
- A large (12.5×8.5 cm), heterogeneous, partially ill-defined mesenteric mass was identified.
- Contrast-enhanced CT showed nonhomogeneous enhancement with hypodense areas and multiple tumor vessels during the arterial phase.
Conclusions:
- Perivascular epithelioid cell tumors (PEComas) should be included in the differential diagnosis for mesenteric lesions.
- Distinguishing PEComas from other mesenteric masses based solely on imaging criteria can be challenging.
