Case 344: Hepatic Epithelioid Hemangioendothelioma

Area of Science:

• Gastroenterology
• Radiology

Background:

• A previously healthy 33-year-old woman presented with several months of intermittent right upper quadrant discomfort, early satiety, bloating, and nausea.
• She had no significant past medical history, including no known malignancy, chronic liver disease, or substance abuse.

Purpose of the Study:

• To investigate the cause of persistent gastrointestinal symptoms in a previously healthy woman.
• To evaluate liver findings using advanced imaging techniques.

Main Methods:

• Abdominal and pelvic CT with intravenous contrast.
• Abdominal MRI with and without intravenous contrast.
• Laboratory studies including hepatic function panel and serum tumor markers were performed.

Main Results:

• Physical examination and laboratory studies, including hepatic function panel and serum tumor markers (alpha-fetoprotein, carcinoembryonic antigen, cancer antigen 19-9), were within normal limits.
• CT of the abdomen and pelvis revealed no extrahepatic pathologic features.
• MRI of the abdomen was performed for further evaluation of liver findings.

Conclusions:

• Further evaluation of liver findings was deemed necessary.
• The cause of the patient's gastrointestinal symptoms required further investigation despite normal initial workup.