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Gastrointestinal
Diagnosis
Liver
Malignant Neoplasms
Epithelioid Hemangioendothelioma
Epithelioid Hemangioendothelioma
Atif Zaheer, MD; Michael P. Federle, MD, FACR
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KEY FACTS

  • Imaging

    • Top Differential Diagnoses

      • Pathology

        • Diagnostic Checklist

          TERMINOLOGY

          • Abbreviations

            • Epithelioid hemangioendothelioma (EHE)

          • Synonyms

            • Hepatic EHE

          • Definitions

            • Primary malignant tumor of liver arising from vascular elements of mesenchymal tissue

          IMAGING

          • General Features

            • CT Findings

              • MR Findings

                • Ultrasonographic Findings

                  • Angiographic Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Gross Pathologic & Surgical Features

                            • Microscopic Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Consider

                                        • Image Interpretation Pearls

                                          Selected References

                                          1. Jang JK et al: A review of the spectrum of imaging manifestations of epithelioid hemangioendothelioma. AJR Am J Roentgenol. 215(5):1290-8, 2020
                                          2. Sanduzzi-Zamparelli M et al: Hepatic epithelioid hemangioendothelioma: an international multicenter study. Dig Liver Dis. 52(9):1041-6, 2020
                                          3. Virarkar M et al: Hepatic hemangioendothelioma: an update. World J Gastrointest Oncol. 12(3):248-66, 2020
                                          4. Cao L et al: Selection of treatment for hepatic epithelioid hemangioendothelioma: a single-center experience. World J Surg Oncol. 17(1):183, 2019
                                          5. Rosenberg A et al: Epithelioid hemangioendothelioma: update on diagnosis and treatment. Curr Treat Options Oncol. 19(4):19, 2018
                                          6. Kim EH et al: CT and MR imaging findings of hepatic epithelioid hemangioendotheliomas: emphasis on single nodular type. Abdom Imaging. 40(3):500-9, 2014
                                          7. Paolantonio P et al: MRI of hepatic epithelioid hemangioendothelioma (HEH). J Magn Reson Imaging. 40(3):552-8, 2014
                                          8. Remiszewski P et al: Epithelioid hemangioendothelioma of the liver as a rare indication for liver transplantation. World J Gastroenterol. 20(32):11333-9, 2014
                                          9. Agrawal N et al: Liver transplantation in the management of hepatic epithelioid hemangioendothelioma: a single-center experience and review of the literature. Transplant Proc. 43(7):2647-50, 2011
                                          10. Amin S et al: Hepatic epithelioid hemangioendothelioma: MR imaging findings. Abdom Imaging. 36(4):407-14, 2011
                                          11. Bruegel M et al: Hepatic epithelioid hemangioendothelioma: findings at CT and MRI including preliminary observations at diffusion-weighted echo-planar imaging. Abdom Imaging. 36(4):415-24, 2011
                                          12. Chen Y et al: Contrast-enhanced multiple-phase imaging features in hepatic epithelioid hemangioendothelioma. World J Gastroenterol. 17(30):3544-53, 2011
                                          13. Kim SJ et al: Unusual extrahepatic metastasis to the soft tissue of the left cervical neck area from hepatic epithelioid hemangioendothelioma. Hepatology. 54(4):1480-1, 2011
                                          14. Liu YI et al: Hepatic epithelioid hemangioendothelioma. Dig Dis Sci. 56(2):303-6, 2011
                                          15. Komatsu Y et al: Malignant hepatic epithelioid hemangioendothelioma with rapid progression and fatal outcome. Intern Med. 49(12):1149-53, 2010
                                          16. Paolantonio P et al: Hepatic epithelioid hemangioendothelioma (HEH) at MRI using reticuloendothelial system (RES)-specific contrast agent: the "bright-bright sign" rather than the "bright-dark sign". J Magn Reson Imaging. 29(4):994-5; author reply 995, 2009
                                          17. Suga K et al: F-18 FDG PET/CT monitoring of radiation therapeutic effect in hepatic epithelioid hemangioendothelioma. Clin Nucl Med. 34(3):199-202, 2009
                                          18. Uchimura K et al: Hepatic epithelioid hemangioendothelioma. J Clin Gastroenterol. 32(5):431-4, 2001
                                          19. Kehagias DT et al: Hepatic epithelioid hemangioendothelioma: MR imaging findings. Hepatogastroenterology. 47(36):1711-3, 2000
                                          20. Lauffer JM et al: Epithelioid hemangioendothelioma of the liver. A rare hepatic tumor. Cancer. 78(11):2318-27, 1996
                                          21. Buetow PC et al: Malignant vascular tumors of the liver: radiologic-pathologic correlation. Radiographics. 14(1):153-66; quiz 167-8, 1994
                                          22. Furuta K et al: Epithelioid hemangioendothelioma of the liver diagnosed by liver biopsy under laparoscopy. Am J Gastroenterol. 87(6):797-800, 1992
                                          23. Miller WJ et al: Epithelioid hemangioendothelioma of the liver: imaging findings with pathologic correlation. AJR Am J Roentgenol. 159(1):53-7, 1992
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Imaging

                                            • Top Differential Diagnoses

                                              • Pathology

                                                • Diagnostic Checklist

                                                  TERMINOLOGY

                                                  • Abbreviations

                                                    • Epithelioid hemangioendothelioma (EHE)

                                                  • Synonyms

                                                    • Hepatic EHE

                                                  • Definitions

                                                    • Primary malignant tumor of liver arising from vascular elements of mesenchymal tissue

                                                  IMAGING

                                                  • General Features

                                                    • CT Findings

                                                      • MR Findings

                                                        • Ultrasonographic Findings

                                                          • Angiographic Findings

                                                            • Imaging Recommendations

                                                              DIFFERENTIAL DIAGNOSIS

                                                                PATHOLOGY

                                                                • General Features

                                                                  • Gross Pathologic & Surgical Features

                                                                    • Microscopic Features

                                                                      CLINICAL ISSUES

                                                                      • Presentation

                                                                        • Demographics

                                                                          • Natural History & Prognosis

                                                                            • Treatment

                                                                              DIAGNOSTIC CHECKLIST

                                                                              • Consider

                                                                                • Image Interpretation Pearls

                                                                                  Selected References

                                                                                  1. Jang JK et al: A review of the spectrum of imaging manifestations of epithelioid hemangioendothelioma. AJR Am J Roentgenol. 215(5):1290-8, 2020
                                                                                  2. Sanduzzi-Zamparelli M et al: Hepatic epithelioid hemangioendothelioma: an international multicenter study. Dig Liver Dis. 52(9):1041-6, 2020
                                                                                  3. Virarkar M et al: Hepatic hemangioendothelioma: an update. World J Gastrointest Oncol. 12(3):248-66, 2020
                                                                                  4. Cao L et al: Selection of treatment for hepatic epithelioid hemangioendothelioma: a single-center experience. World J Surg Oncol. 17(1):183, 2019
                                                                                  5. Rosenberg A et al: Epithelioid hemangioendothelioma: update on diagnosis and treatment. Curr Treat Options Oncol. 19(4):19, 2018
                                                                                  6. Kim EH et al: CT and MR imaging findings of hepatic epithelioid hemangioendotheliomas: emphasis on single nodular type. Abdom Imaging. 40(3):500-9, 2014
                                                                                  7. Paolantonio P et al: MRI of hepatic epithelioid hemangioendothelioma (HEH). J Magn Reson Imaging. 40(3):552-8, 2014
                                                                                  8. Remiszewski P et al: Epithelioid hemangioendothelioma of the liver as a rare indication for liver transplantation. World J Gastroenterol. 20(32):11333-9, 2014
                                                                                  9. Agrawal N et al: Liver transplantation in the management of hepatic epithelioid hemangioendothelioma: a single-center experience and review of the literature. Transplant Proc. 43(7):2647-50, 2011
                                                                                  10. Amin S et al: Hepatic epithelioid hemangioendothelioma: MR imaging findings. Abdom Imaging. 36(4):407-14, 2011
                                                                                  11. Bruegel M et al: Hepatic epithelioid hemangioendothelioma: findings at CT and MRI including preliminary observations at diffusion-weighted echo-planar imaging. Abdom Imaging. 36(4):415-24, 2011
                                                                                  12. Chen Y et al: Contrast-enhanced multiple-phase imaging features in hepatic epithelioid hemangioendothelioma. World J Gastroenterol. 17(30):3544-53, 2011
                                                                                  13. Kim SJ et al: Unusual extrahepatic metastasis to the soft tissue of the left cervical neck area from hepatic epithelioid hemangioendothelioma. Hepatology. 54(4):1480-1, 2011
                                                                                  14. Liu YI et al: Hepatic epithelioid hemangioendothelioma. Dig Dis Sci. 56(2):303-6, 2011
                                                                                  15. Komatsu Y et al: Malignant hepatic epithelioid hemangioendothelioma with rapid progression and fatal outcome. Intern Med. 49(12):1149-53, 2010
                                                                                  16. Paolantonio P et al: Hepatic epithelioid hemangioendothelioma (HEH) at MRI using reticuloendothelial system (RES)-specific contrast agent: the "bright-bright sign" rather than the "bright-dark sign". J Magn Reson Imaging. 29(4):994-5; author reply 995, 2009
                                                                                  17. Suga K et al: F-18 FDG PET/CT monitoring of radiation therapeutic effect in hepatic epithelioid hemangioendothelioma. Clin Nucl Med. 34(3):199-202, 2009
                                                                                  18. Uchimura K et al: Hepatic epithelioid hemangioendothelioma. J Clin Gastroenterol. 32(5):431-4, 2001
                                                                                  19. Kehagias DT et al: Hepatic epithelioid hemangioendothelioma: MR imaging findings. Hepatogastroenterology. 47(36):1711-3, 2000
                                                                                  20. Lauffer JM et al: Epithelioid hemangioendothelioma of the liver. A rare hepatic tumor. Cancer. 78(11):2318-27, 1996
                                                                                  21. Buetow PC et al: Malignant vascular tumors of the liver: radiologic-pathologic correlation. Radiographics. 14(1):153-66; quiz 167-8, 1994
                                                                                  22. Furuta K et al: Epithelioid hemangioendothelioma of the liver diagnosed by liver biopsy under laparoscopy. Am J Gastroenterol. 87(6):797-800, 1992
                                                                                  23. Miller WJ et al: Epithelioid hemangioendothelioma of the liver: imaging findings with pathologic correlation. AJR Am J Roentgenol. 159(1):53-7, 1992