Multifocal Pulmonary Epithelioid Hemangioendothelioma: A Metastatic Disease Mimicker

We present the case of a 79-year-old woman with multiple bilateral pulmonary nodules identified during an investigation for abdominal pain, initially suspected to represent metastatic disease. Extensive clinical, laboratory, and imaging workup failed to reveal a primary origin. After two non-diagnostic transthoracic biopsies, the patient underwent single-port video-assisted thoracoscopic surgery (VATS) with excision of two nodules from the upper and lower lobes of the right lung. Histopathological examination revealed an epithelioid hemangioendothelioma (EHE), a rare vascular neoplasm. This case illustrates the diagnostic process and pathological features of pulmonary EHE, with a brief clinical overview.