Zhou JA, Fan ZC, Zheng RJ, Guo QX, Su S. Diagnostic challenges and radiological insights of rare hepatic perivascular epithelioid cell tumor: A case report and review of the literature. World J Gastrointest Surg 2025; 17(5): 105220 [DOI: 10.4240/wjgs.v17.i5.105220]
Corresponding Author of This Article
Song Su, MD, Professor, Department of General Surgery (Hepatobiliary Surgery), The Affiliated Hospital of Southwest Medical University, No. 25 Taiping Street, Luzhou 646000, Sichuan Province, China. 13882778554@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. May 27, 2025; 17(5): 105220 Published online May 27, 2025. doi: 10.4240/wjgs.v17.i5.105220
Diagnostic challenges and radiological insights of rare hepatic perivascular epithelioid cell tumor: A case report and review of the literature
Jun-An Zhou, Zheng-Chao Fan, Ru-Jun Zheng, Qin-Xi Guo, Song Su
Jun-An Zhou, Ru-Jun Zheng, Song Su, Department of General Surgery (Hepatobiliary Surgery), The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
Zheng-Chao Fan, Department of Ultrasound, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
Qin-Xi Guo, Department of Pathology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
Co-first authors: Jun-An Zhou and Zheng-Chao Fan.
Author contributions: Zhou JA and Fan ZC contributed equally to this study as co-first authors; Zhou JA and Zheng RJ were responsible for the overall management of the patient and wrote the manuscript; Fan ZC provided interpretations of the imaging findings; Guo QX provided pathological expertise and interpretations; Su S contributed to manuscript revisions; all authors reviewed and approved the final manuscript.
Supported by National Natural Science Foundation of China, No. U22A2039.
Informed consent statement: Written informed consent was obtained from the patient for the publication of this case report, including all relevant medical data and accompanying images. The patient was informed that her personal information would remain confidential and that all efforts would be made to protect her privacy.
Conflict-of-interest statement: The authors declare no conflicts of interest related to the publication of this case report.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Song Su, MD, Professor, Department of General Surgery (Hepatobiliary Surgery), The Affiliated Hospital of Southwest Medical University, No. 25 Taiping Street, Luzhou 646000, Sichuan Province, China. 13882778554@163.com
Received: January 15, 2025 Revised: February 27, 2025 Accepted: March 21, 2025 Published online: May 27, 2025 Processing time: 128 Days and 15.4 Hours
Abstract
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.
Core Tip: Hepatic perivascular epithelioid cell tumor is a rare liver tumor with nonspecific clinical and imaging features, often leading to misdiagnosis. This case highlights the importance of combining radiological and immunohistochemical evaluations for accurate diagnosis. The significant growth of the lesion observed in this patient emphasizes the need for timely surgical intervention. Long-term follow-up is essential to monitor for recurrence or metastasis.
