Hepatic epithelioid hemangioendothelioma: a report from three university centers.
OBJECTIVE
To determine common imaging findings of hepatic epithelioid hemangioendothelioma on magnetic resonance images.


METHODS
A search was made of three institutional databases between January 2000 and August 2012. Seven patients (mean age, 47 years; range, 21-66 years; 6 women) with pathology-confirmed diagnosis of hepatic epithelioid hemangioendothelioma who had undergone magnetic resonance imaging were identified. None of the patients had received any treatment for hepatic epithelioid hemangioendothelioma at the time of the initial magnetic resonance imaging examination.


RESULTS
Hepatic epithelioid hemangioendothelioma tumors appeared as focal masses in 7/7 patients, greater than 5 in number, with a coalescing lesion in 1/5, and peripheral localization in 6/7. Capsular retraction was present in 4/7, and was associated with peripherally located lesions. Early ring enhancement was appreciated in the majority of lesions in 7/7 patients. Centripetal progressive enhancement was shown in 5/7 patients on venous phase that exhibited a distinctive thick inner border of low signal on venous phase images, and a central core of delayed enhancement. Small lesions did not show this.


CONCLUSIONS
The combination of multifocal round-configuration lesions that are predominantly peripheral and exhibit early peripheral ring enhancement and late appearance of an inner thick border of low signal and central core of high signal may represent an important feature for hepatic epithelioid hemangioendothelioma.
MD, Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Universitá degli Studi di Milano, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
Antonello
A
Giardino
MD, FACR, Department of Radiology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Frank H
FH
Miller
MD, Department of Radiology, University of Arizona Medical Center, Tucson, Arizona, USA; Department of Radiology, The Emory Clinic, Wesley Woods Geriatric Hospital, Atlanta, GA, USA.
Bobby
B
Kalb
Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Radiology, Hospital Garcia de Orta, Almada, Portugal.
Miguel
M
Ramalho
MD, PhD, Department of Radiology, University of Arizona Medical Center, Tucson, Arizona, USA; Department of Radiology, The Emory Clinic, Wesley Woods Geriatric Hospital, Atlanta, GA, USA.
Diego R
DR
Martin
MD, Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Ecomax - Centro de Diagnóstico por Imagem, Blumenau, SC, Brazil.
Karina
K
Rodacki
MD, PhD, Department of Pathology & Laboratory Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
John T
JT
Woosley
MD, Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Richard C
RC
Semelka
Epithelioid hemangioendothelioma; Liver neoplasms/diagnosis; Magnetic resonance imaging