PMC5114688_01
Dynamic contrast-enhanced CT image showing an approximately 5-cm, well-circumscribed tumor adjacent to the IVC (arrowhead in A) and the RHV (arrow in B) in segment 7. A) Heterogeneous enhancement was visible during the arterial to portal phase of the CT examination. B) The heterogeneous enhancement persisted until the equilibrium phase.
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The lesion was adjacent to the inferior vena cava (IVC) and the right hepatic vein (RHV) (Fig. 1A and B).
A, B: Magnetic resonance images. A) A T1-weighted image shows a hypointense tumor (arrow). B) A T2-weighted image shows a hyperintense tumor (arrow). C, D: Gadolinium-ethoxybenzyl-diethylenetriamine penta-acetic acid-enhanced (EOB) MRI shows a defect (arrow) during the hepatobiliary phase. C) Axial image. D) Coronal image.
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Gadolinium-ethoxybenzyl-diethylenetriamine penta-acetic acid-enhanced MRI (EOB-MRI) scans revealed a well-circumscribed tumor that was hypointense on T1-weighted images and hyperintense on T2-weighted images (Fig. 2A and B). After the injection of EOB as a contrast agent, a defect during the hepatobiliary phase was observed (Fig. 2C and D).
A) US shows a multicystic tumor with numerous septa (arrow). B) Even after the division of the liver parenchyma, the specimen was still attached to the IVC (arrow head).
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IVC. Intraoperative US showed a multicystic tumor with numerous septa (Fig. 3A). Even after the complete division of the liver parenchyma, the detachment of the tumor from the IVC was still difficult (Fig. 3B).
Macroscopic image of the tumor A) A white tumor was resected together with a portion of the IVC. B) The cut surface showed multiple cysts.
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Macroscopically, a clearly demarcated white-gray tumor with focal cystic changes was observed (Fig. 4A and B).
Microscopic image of the tumor A) The tumor consisted of Antoni A and B areas. The Antoni A area was rich in spindle cells. The Antoni B area contained a myxoid component with a low density of tumor cells. B) Verocay bodies with nuclear palisading (arrows) are visible.
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The Antoni B area was composed of a myxoid component in which the tumor cellular density was relatively low (Fig. 5A). The nuclear palisading formation of the tumor exhibited Verocay bodies and there were few nuclear atypias and mitotic counts (Fig. 5B).