Multicentric epithelioid hemangioendothelioma; an entity with danger of misdiagnosis

Epithelioid hemangioendothelioma (EH) is a rare neoplasm of vascular orgin with uncertain malignant potential, known to involve many organs. In terms of behavior it is considered to be intermediate between angiomas at the benign end and angiosarcoma at the malignant end. The rarity of the condition, non-specific symptoms and lack of clinical experience can cause misdiagnosis. EH can present as a single organ disease or involve several organs, either as concurrent disease or as metastatic disease. The involvement of multiple organs can result in EH being mistaken for other conditions like metastatic carcinoma, granulomatous diseases etc, at the clinical and radiological level. We are presenting a case of EH with multiorgan involvement. With a clinical and radiological diagnosis of metastatic carcinoma a trucut biopsy was taken from liver. Diagnosis of EH was made based on histopathological and immunohistochemical findings. We are presenting this case to highlight the importance of knowing this entity so that diagnostic errors and subsequent treatment for unrelated conditions can be avoided.