A pathology department in Karachi reviewed 14 years of records and found seven cases of a particular liver tumor. In every single one, the clinical differential before biopsy had been something else: metastatic carcinoma or multifocal hepatocellular carcinoma.
Seven for seven. That is the story of hepatic epithelioid hemangioendothelioma, a vascular tumor rare enough that most oncologists will see a handful in a career, and distinctive enough on a microscope slide that nobody argues once the tissue is in hand.
