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Laparoscopic partial hepatectomy for primary hepatic PEComa: a case report.

Bing Liang1,2, Hongjin Shi3, Qingbin Zeng1

  • 1Department of Hepatopancreatobiliary Surgery, The Second Affiliated Hospital of Kunming Medical University, No. 374 Dianmian Road, Kunming, Yunnan, 650101, China.

BMC Gastroenterology
|May 2, 2026
PubMed
Summary

Perivascular epithelioid cell tumors (PEComas) are rare liver tumors. This case highlights diagnostic challenges and successful surgical management of a large hepatic PEComa in a young male patient.

Keywords:
Case reportDifferential diagnosisHepatic PEComaLaparoscopic hepatectomyLiver cancerPerivascular epithelioid cell tumor

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Area of Science:

  • Oncology
  • Pathology
  • Surgical Gastroenterology

Background:

  • Perivascular epithelioid cell tumors (PEComas) are rare mesenchymal neoplasms.
  • PEComas exhibit dual differentiation of smooth muscle cells and melanocytes.
  • Diagnosis is challenging due to nonspecific symptoms and imaging findings.

Purpose of the Study:

  • To present a case of a large hepatic PEComa in a young male.
  • To detail the diagnostic process, including imaging characteristics.
  • To describe the surgical management and outcomes for hepatic PEComa.

Main Methods:

  • A 31-year-old male presented with an incidentally discovered hepatic lesion.
  • Comprehensive imaging (ultrasound, CT, MRI) was performed.
  • Laparoscopic partial hepatectomy was conducted, followed by histopathological analysis.

Main Results:

  • Imaging suggested hepatocellular carcinoma, necessitating differential diagnosis.
  • Histopathology confirmed a PEComa with undetermined malignant potential.
  • The patient experienced an uneventful recovery and was discharged.

Conclusions:

  • PEComas are rare with insidious onset and challenging early diagnosis.
  • Imaging findings are often nonspecific, with biopsy crucial for diagnosis.
  • Radical resection (R0) is the definitive treatment for PEComa.