case_images: PMC8236603_01
case_images: Abdominal CT scan demonstrating a 15 mm hypervascular lesion in segment VII of the liver in arterial phase (A) and venous phase (B).
case_images: fsurg-08-691674-g0001.jpg
case_images: PMC8236603_01_fsurg-08-691674-g0001.jpg
case_images: F1
case_images: Further contrast-enhanced computed tomography (CT) scan confirmed a 15 mm hypervascular lesion in segment VII (Figure 1).
case_images: MRI of the liver. (A) Hypointense signal on T1-weighted sequences. (B) Hyperintense signal on T2-weighted sequences. (C) Complete homogenous enhancement in post-contrast arterial phase. (D) Hypointense signal in hepatobiliary delayed phase.
case_images: fsurg-08-691674-g0002.jpg
case_images: PMC8236603_01_fsurg-08-691674-g0002.jpg
case_images: F2
case_images: T1-weighted sequences and hyperintense signal on T2-weighted sequences with complete homogenous enhancement in post-contrast arterial phase and hypointense signal in hepatobiliary delayed phase (Figure 2). These findings suggested portal vein aneurysm, arteriovenous aneurysm, or hepatocellular adenoma in the differential diagnosis.
case_images: Histologic analysis. (A) The well-demarcated and unencapsulated tumor is seen in the liver. (B) The tumor is composed of fascicles featuring cells with bland, elongated cigar shaped nuclei and eosinophilic cytoplasm. (C) Higher magnification depicting bland tumor cells with cigar shaped nuclei and indistinct eosinophilic cytoplasm. Note the absence of mitotic activity. (D) Palisading of the nuclei was present at many tumor foci.
case_images: fsurg-08-691674-g0003.jpg
case_images: PMC8236603_01_fsurg-08-691674-g0003.jpg
case_images: F3
case_images: Histologic analysis revealed a well-demarcated and unencapsulated tumor within the liver (Figure 3A), composed of fascicles of bland tumor cells with elongated cigar shaped nuclei and eosinophilic cytoplasm with indistinct borders (Figures 3B,C). Focal palisading of the tumor cell nuclei was present at many areas (Figure 3D).
case_images: Immunohistochemistry. While tumor cells are diffusely positive for calponin (A), h-Caldesmon (B) and smooth muscle actin (C), only about 60% of the tumor cells display desmin positivity (D).
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case_images: PMC8236603_01_fsurg-08-691674-g0004.jpg
case_images: F4
case_images: By immunohistochemistry, the tumor cells were diffusely positive for h-Caldesmon, calponin, and smooth muscle actin, while only about 60% of tumor cells displayed strong positivity for desmin (Figure 4).