Zhou Jun-An, Fan Zheng-Chao, Zheng Ru-Jun, Guo Qin-Xi, Su Song
Department of General Surgery (Hepatobiliary Surgery), The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China.
Department of Ultrasound, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China.
World J Gastrointest Surg. 2025 May 27;17(5):105220. doi: 10.4240/wjgs.v17.i5.105220.
Hepatic perivascular epithelioid cell tumor (PEComa) is an extremely rare neoplasm that is often difficult to diagnose due to its nonspecific clinical and radiological features. This case emphasizes the importance of imaging and histopathological examination in distinguishing PEComa from other liver tumors, and the necessity of early intervention.
A 36-year-old woman presented with a liver mass discovered during a routine physical examination. Initially diagnosed as focal nodular hyperplasia based on contrast-enhanced computed tomography, she declined surgical intervention. Two years later, re-examination revealed an approximately 60% increase in the size of the mass and suggested the possibility of hepatocellular carcinoma. She subsequently underwent surgical resection. Postoperative histopathological and immunohistochemical analysis revealed positivity for HMB-45 and Melan-A, confirming the diagnosis of hepatic PEComa. A 13-month follow-up revealed no recurrence or metastasis.
Hepatic PEComa requires a combination of radiological and immunohistochemical evaluation for accurate diagnosis. This case highlights the importance of early surgical intervention and regular follow-up to monitor for recurrence or metastasis.
肝血管周上皮样细胞肿瘤（PEComa）是一种极其罕见的肿瘤，由于其非特异性的临床和放射学特征，常难以诊断。本病例强调了影像学和组织病理学检查在鉴别PEComa与其他肝脏肿瘤中的重要性，以及早期干预的必要性。
一名36岁女性在常规体检中发现肝脏肿物。最初根据增强计算机断层扫描诊断为局灶性结节性增生，她拒绝了手术干预。两年后，复查显示肿物大小增加了约60%，提示肝细胞癌的可能性。她随后接受了手术切除。术后组织病理学和免疫组化分析显示HMB-45和Melan-A呈阳性，确诊为肝PEComa。13个月的随访显示无复发或转移。
肝PEComa需要结合放射学和免疫组化评估以准确诊断。本病例突出了早期手术干预和定期随访以监测复发或转移的重要性。
