Imaging findings of hepatic epithelioid hemangioendothelioma and fibrolamellar hepatocellular carcinoma: a critical appraisal of current literature about imaging features of two rare liver cancers

Hepatic epithelioid hemangioendothelioma (HEHE) and fibrolamellar carcinoma (FLC) are two rare primary neoplasm of the liver, usually involving young subjects without underlying chronic liver disease, contrarily to hepatocellular carcinoma (HCC) (1). The paucity of consistent data available in current literature related to the uncommonness of the cases, make the final diagnosis of these cancers difficult with imaging techniques alone. Accordingly, main features of HEHE and FLC may not be familiar to physicians and it is not possible to identify a target population to screen. However, both diseases show harsh prognostic impact when identified in advanced stage. Thus, the current role of imaging in the diagnosis of these cancers is based on the early identification of their malignant nature, prompting biopsy for pathological definitive examination