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Joseph Junewick, MD FACR
over 7 years ago
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Hemangioendothelioma of liver

Case Detail

Anatomy: Vascular-Lymphatic
Borders
Heather Borders, MD
Diagnostic Category: Neoplasia Benign
Created: over 5 years ago
Updated: over 5 years ago
Tags: PEDS
Modality/Study Types: CT US
Activities:
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History

Infant with hepatomegaly


Case Images


Diagnosis

Hemangioendothelioma of liver

Findings

Large liver mass. Hypodense centrally with peripheral enhancement on CT. Mild tapering of the aorta; larger above the liver and smaller below suggesting hypervascularity. Follow up ultrasound demonstrates decrease in the size of the mass with central calcification after treatment.

Discussion

Hemangioendothelioma can be used interchangeably with hemangioma. Differentiation requires pathology. These lesions are most common in premature caucasian females. Lesions present before 6 months of age. Composed of rapidly proliferating endothelial cells. Hemangioendotheliomas have slightly more aggressive features histologically.

Clinical presentation varies; no symptoms to coagulopathy and heart failure. Those with CHF tend to have large lesions at birth.

Findings on imaging include a well defined and lobulated enhancing mass that may contain flow voids or calcifications. Multiple hemangiomas tend to be low density on precontrast CT and bright on T2 and enhance homogeneously on contrast enhanced CT or MRI. Larger lesions are more likely to have centripetal enhancement or an avascular center.

Prognosis is generally very good. Death is possible due to coagulopathy, hemorrhage or CHF.

Reference

Caffeys Diagnostic Imaging. Eleventh Edition, volume 2. Pages 1941-1943.



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