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A case of complex hemangioendothelioma of the liver in an infant
Wenpeng Huang1, Liming Li2, Jianbo Gao2
1Nuclear Medicine, Peking University First Hospital.
Insights
A rare pediatric liver tumor, composite hemangioendothelioma (CHE), was diagnosed in an infant presenting with gastrointestinal symptoms. Surgical resection and pathological analysis confirmed this complex vascular tumor.
Area of Science:
- Pediatric pathology
- Vascular tumors
- Hepatobiliary diseases
Background:
- Composite hemangioendothelioma (CHE) is a rare, complex vascular tumor typically affecting infants and children.
- Distinguishing CHE from other liver lesions can be challenging due to its varied histopathological features.
Observation:
- A 9-month-old infant presented with vomiting, diarrhea, and abdominal tenderness.
- Imaging revealed a liver lesion with specific characteristics on ultrasound and CT.
- Pathology showed a combination of epithelioid hemangioendothelioma and cavernous hemangioma components.
Findings:
- Postoperative pathology confirmed composite hemangioendothelioma (CHE).
- Immunohistochemistry was positive for CD34, CD31, FLI-1, and F-VIII, supporting the diagnosis.
- The tumor demonstrated internal focal calcification and delayed heterogeneous enhancement on CT.
Implications:
- This case highlights the importance of comprehensive histopathological and immunohistochemical evaluation for diagnosing rare pediatric liver tumors.
- Accurate diagnosis of CHE is crucial for appropriate management and prognosis in pediatric patients.
- Further research into the pathogenesis and optimal treatment strategies for CHE is warranted.
Abstract:
A physical examination of a 9-month-old female infant presenting with vomiting and diarrhea revealed tenderness in the right upper abdomen and heightened abdominal muscle tone. Abdominal ultrasonography identified an irregular hypoechoic area within the right lobe of the liver. While a subsequent enhanced CT examination disclosed a well-defined lesion exhibiting internal focal calcification and delayed heterogeneous enhancement. Subsequently, she underwent surgical resection, and postoperative pathology revealed areas of epithelioid hemangioendothelioma and cavernous hemangioma. Immunohistochemistry demonstrated positive expression of CD34, CD31, FLI-1, and F-VIII. The pathologic diagnosis was confirmed as composite hemangioendothelioma (CHE).
