Multifocal primary hepatic epithelioid hemangioendothelioma: a case in which tumor biopsy was critical to prevent misdiagnosis.

Hepatic epithelioid hemangioendothelioma is rare, and because its imaging findings are nonspecific, pathological evaluation is essential for definitive diagnosis. In this 82‑year‑old woman, multiple hepatic masses were incidentally detected on contrast‑enhanced CT during postoperative surveillance for bladder cancer, and concurrent local recurrence made metastasis the leading suspicion. However, immunohistopathological examination of a liver biopsy excluded metastatic carcinoma and confirmed primary hepatic epithelioid hemangioendothelioma. She died of liver failure. This case underscores the need to consider diagnoses other than metastatic liver cancer and to perform an appropriate differential workup, even in patients with multiple hepatic lesions and a history of malignancy.