Contrast-Enhanced Ultrasound of a Hepatic Perivascular Epithelioid Cell Tumor: A Case Report and Literature Review.

Primary hepatic perivascular epithelioid cell tumor (PEComa) is an exceptionally rare mesenchymal neoplasm of borderline malignancy, with limited documentation of its contrast-enhanced ultrasound (CEUS) features in medical literature. In this context, we present a 53-year-old male patient without chronic liver disease, who exhibited a well-circumscribed hypoechoic left hepatic lobe mass on conventional ultrasonography. Subsequent CEUS demonstrated characteristics indicative of malignant tumors, with specific manifestations during the arterial phase, thereby informing clinical decision-making toward surgical resection. Histopathological confirmation of capsular-invasive PEComa underscores the utility of CEUS in characterizing such lesions, particularly in middle-aged patients with incidental solitary hepatic masses lacking predisposing risk factors. These findings advocate for the integration of CEUS into diagnostic algorithms to enhance specificity in atypical hepatic tumor evaluations.