Diagnostic challenges and radiological insights of rare hepatic perivascular epithelioid cell tumor: A case report and review of the literature.

BACKGROUND

Hepatic perivascular epithelioid cell tumor (PEComa) is an extremely rare neoplasm that is often difficult to diagnose due to its nonspecific clinical and radiological features. This case emphasizes the importance of imaging and histopathological examination in distinguishing PEComa from other liver tumors, and the necessity of early intervention.

CASE SUMMARY: A 36-year-old woman presented with a liver mass discovered during a routine physical examination. Initially diagnosed as focal nodular hyperplasia based on contrast-enhanced computed tomography, she declined surgical intervention. Two years later, re-examination revealed an approximately 60% increase in the size of the mass and suggested the possibility of hepatocellular carcinoma. She subsequently underwent surgical resection. Postoperative histopathological and immunohistochemical analysis revealed positivity for HMB-45 and Melan-A, confirming the diagnosis of hepatic PEComa. A 13-month follow-up revealed no recurrence or metastasis.

CONCLUSION

Hepatic PEComa requires a combination of radiological and immunohistochemical evaluation for accurate diagnosis. This case highlights the importance of early surgical intervention and regular follow-up to monitor for recurrence or metastasis.