case_images: PMC11254673_01
case_images: PMC11254673_02
case_images: PMC11254673_03
case_images: CT scan showed a 27 mm-large tumor localized in segment 7/8 (A) with rapid contrast enhancement in the arterial phase (B) and washout in venous (C) and delayed phase (D). Because of radiological characteristic HCC was suspected.
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case_images: Both showed similar CT pattern with rapid enhancement in the arterial phase and washout in the venous phase ( Figure 1 ).
case_images: PMC11254673_04
case_images: Hepatic PEComa. Hematoxylin andeosin (H&E) staining revealed atypical epithelioid cells with abundant eosinophilic cytoplasm. No necrosis and no mitosis have been noticed (A). Immunohistochemically the tumor cells were diffusely positive for HMB45 (B) and focally positive for SMA (C) Negative staining for HepPar1 (D) enable to exclude the hepatocyte origin of tumor. [(A-D),scale bars 50microm.]
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case_images: Microscopically, the tumor cells were composed of epithelioid cells with abundant eosinophilic cytoplasm ( Figure 2A ). Additional immunohistochemical staining results showed that the tumor cells were diffusely positive for HMB45 ( Figure 2B ), focally for Melan-A and SMA ( Figure 2C ) and negative for HepPar-1 ( Figure 2D ), S100, AFP, keratin AE1/AE3, Glypican3, CD117 and DOG-1 markers.
case_images: Time line of case history. PRCC, papillary renal cell carcinoma. CT, computed tomography. HCC, hepatocellular carcinoma. FNB, fine needle biopsy. RFA, radiofrequency ablation.
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case_images: The timeline with relevant data from the episode of care is displayed in  Figure 3 .