A case of hepatic perivascular tumor
Perivascular epithelioid cell tumor (PEComa) of liver is extremely rare hepatic neoplasm with only 30 cases reported in the literature.

These lesions are found mainly in young females and may present a potential pitfall in the characterisation of focal liver lesions. The biological behavior of PEComa varies from generally benign to rarely malignant and metastatic disease.

Published in the European Journal of Radiology Open, the authors report a case of a patient with hepatic PEComa with the corresponding imaging findings on the ultrasound, contrast-enhanced ultrasound (CEUS) and hepatospecific MRI.

After failed attempt to characterize the lesion by percutaneous biopsy, surgical resection was conducted and the final diagnosis was achieved.

Clinical Pearls:-
• Hepatic perivascular epithelioid cell tumor is a rare hepatic neoplasm and may represent a potential pitfall in characterisation of an incidentally discovered liver lesion.

• In the present case the characterization with contrast-enhanced ultrasound (CEUS) was performed, and an arterialized liver lesion was initially mistakenly characterized as FNH or adenoma by using the EFSUMB Guidelines for Contrast Enhanced Ultrasound in the Liver.

• Later growth of the tumor, MRI and histologic examination were used for appropriately diagnosing tumor as hepatic PEComa.

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