Perivascular Epithelioid Cell Tumor (PEComa) of the Liver: a Case Report and
Review of the Literature
Švajdler M. ml., Bohuš P., Goč V.1, Tkáčová V.1
Oddelenie patológie, Fakultná nemocnica L. Pasteura Košice, pracovisko Trieda SNP 1 1Klinika onkológie, Fakultná nemocnica J. A. Reimana, Prešov |
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Summary:
Perivascular epithelioid cell tumor (PEComa) is rare entity and has been described only recently.
By immunohistochemistry and genetics it belongs to the family of tumours which comprises
angiomyolipoma, clear cell “sugar“ tumor of lung, lymphangioleiomyomatosis and clear cell
myomelanotic tumor of ligamentum falciforme/teres hepatis. We describe an unusual case of
hepatic PEComa arising in a 55-year-old woman with previous history of glioblastoma.
Histologically the tumor grew in expansive way, and was composed of clear and eosinophilic
epithelioid cels, without vascular or lipomatous component characteristic of angiomyolipoma.
There was mild nuclear pleomorphism, sporadic mitotic activity and haemorrhage without
necrosis. On immunohistochemistry, the tumor was HMB-45+50, Melan-A and smooth muscle actin
positive. Tyrosinase, S-100 protein, cytokeratin coctail, EMA, vimentin, muscle specific actin, CD10,
TTF-1, hepatocyte, desmin and cyclin D1 were negative. Sporadic nuclear p53 positivity was seen.
The main differential diagnosis of hepatic PEComa includes clear cell variant of liver cell adenoma
and hepatocellular carcinoma, metastases of various clear cell carcinomas and metastasis of
malignant melanoma. In respect of uncertain biologic potential of PEComa, long term follow up is
indicated.
Key words:
perivascular epithelioid cell – PEComa – angiomyolipoma – liver – glioblastoma
multiforme
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