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Peer-reviewedCC BY 4.0ACG Case Reports Journal

Diagnostic Challenge of Primary Hepatic PEComa in a Young Woman with Prior Colorectal Cancer

  • Gerald Odong1
  • Priyanka Panwar2
  • Lavender Otom2
  • Ivy Wakahora1
  • Steven Idet1
  • Sarah Kibe1
  • Patricia Okiro3
  • Saleem Abdulkarim2
  • Ajua Alemanji2
  • Amina Kidee4
  • Samuel Gitau1
4 affiliations
  1. 1Department of Radiology, The Aga Khan University Hospital Nairobi, Nairobi, Kenya
  2. 2Department of Medicine, The Aga Khan University Hospital Nairobi, Nairobi, Kenya
  3. 3Department of Pathology, The Aga Khan University Hospital Nairobi, Nairobi, Kenya
  4. 4Department of Haemato-Oncology, The Aga Khan University Hospital Nairobi, Nairobi, Kenya
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Abstract

Primary hepatic perivascular epithelioid cell tumor (PEComa) is a rare mesenchymal neoplasm that can mimic common hepatic malignancies. A 28-year-old African woman with colorectal cancer in remission presented with 3 months of epigastric pain and tender hepatomegaly. Tumor markers were normal. Ultrasound and triphasic CT showed 2 large heterogeneous hypervascular hepatic masses with progressive enhancement and early venous drainage; hepatobiliary iminodiacetic acid scan (HIDA) SPECT-CT demonstrated photopenic lesions. Biopsy revealed epithelioid cells with focal HMB45, diffuse smooth muscle actin, and Ki-67 20%–30%, confirming hepatic PEComa. Resection was feasible but deferred; everolimus was started before loss to follow-up.

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Cite

BibTeXRIS
BibTeX
@article{odong2026diagnostic,
  title = {{Diagnostic Challenge of Primary Hepatic PEComa in a Young Woman with Prior Colorectal Cancer}},
  author = {Gerald Odong and Priyanka Panwar and Lavender Otom and Ivy Wakahora and Steven Idet and Sarah Kibe and Patricia Okiro and Saleem Abdulkarim and Ajua Alemanji and Amina Kidee and Samuel Gitau},
  journal = {ACG Case Reports Journal},
  year = {2026},
  month = nov,
  doi = {10.14309/crj.0000000000002377},
  url = {https://doi.org/10.14309/crj.0000000000002377},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Diagnostic Challenge of Primary Hepatic PEComa in a Young Woman with Prior Colorectal Cancer
AU  - Gerald Odong
AU  - Priyanka Panwar
AU  - Lavender Otom
AU  - Ivy Wakahora
AU  - Steven Idet
AU  - Sarah Kibe
AU  - Patricia Okiro
AU  - Saleem Abdulkarim
AU  - Ajua Alemanji
AU  - Amina Kidee
AU  - Samuel Gitau
PY  - 2026
DA  - 2026/11/04
JO  - ACG Case Reports Journal
DO  - 10.14309/crj.0000000000002377
UR  - https://doi.org/10.14309/crj.0000000000002377
AB  - Primary hepatic perivascular epithelioid cell tumor (PEComa) is a rare mesenchymal neoplasm that can mimic common hepatic malignancies. A 28-year-old African woman with colorectal cancer in remission presented with 3 months of epigastric pain and tender hepatomegaly. Tumor markers were normal. Ultrasound and triphasic CT showed 2 large heterogeneous hypervascular hepatic masses with progressive enhancement and early venous drainage; hepatobiliary iminodiacetic acid scan (HIDA) SPECT-CT demonstrated photopenic lesions. Biopsy revealed epithelioid cells with focal HMB45, diffuse smooth muscle actin, and Ki-67 20%–30%, confirming hepatic PEComa. Resection was feasible but deferred; everolimus was started before loss to follow-up.
SN  - 2326-3253
ER  -