Presentation
Right upper abdominal pain.
Patient Data
Multiple hypoattenuating lesions in both hepatic lobes in a peripheral/subcapsular distribution, with a target pattern of enhancement. The confluent lesion in segments 6 and 7 shows capsular retraction.
Branches of hepatic and portal veins are seen tapering and terminating just within the edge of these lesions (lollipop sign).
Status post cholecystectomy.
Small renal calculi in both kidneys.
Case Discussion
This is a case of pathology proven hepatic epithelioid hemangioendothelioma, which is a rare vascular tumor. The case illustrates typical imaging features of the tumor - peripheral distribution of the lesions, capsular retraction, and lollipop sign.