Primary hepatic leiomyosarcoma:A case report and literature review  

作　　者：Hassan Ahmed Hassaan Bari Umer Nisar Sheikh Muhammad Irfan Basheer 

机构地区：[1]Department of Surgical Oncology,Shaukat Khanum Memorial Cancer Hospital and Research Centre,Lahore 54782,Pakistan [2]Department of Pathology,Shaukat Khanum Memorial Cancer Hospital and Research Centre,Lahore 54782,Pakistan

出　　处：《World Journal of Hepatology》2022年第9期1830-1839,共10页世界肝病学杂志（英文版）（电子版）

摘　　要：BACKGROUND Primary hepatic leiomyosarcoma(PHL)is a rare tumor with a very low incidence of about 0.2%.CASE SUMMARY A 48-year-old diabetic,hypertensive,and morbidly obese female patient presented with a history of abdominal pain and weight loss for 2 mo.She had no history of fever,jaundice,or other liver disease(s).Clinical examination revealed a palpable mass in the epigastrium.Imaging evaluation with a contrast-enhanced computed tomography(CT)scan of the abdomen and pelvis revealed an illdefined enhancing hyper vascular hepatic mass of 9.9 cm×7.8 cm occupying the left hepatic lobe with evidence of central necrosis,compression effect on the left hepatic vein,and partial wash-out on delayed images.On further workup,the maximum standardized uptake value on positron emission computed tomography scan was 6.4,which was suggestive of malignancy.The remaining part of the liver was normal without any evidence of cirrhosis.Ultrasound-guided biopsy of the mass showed smooth muscle neoplasm suggestive of leiomyos-arcoma.After optimization for co-morbidities,an extended left hepatectomy was planned in a multidisciplinary team meeting.On intraoperative ultrasound,the left hepatic lobe was entirely replaced by a large tumor extending to the caudate lobe with a compression effect on the middle and left hepatic veins.Final histopathology showed nodular and whorled white tumor comprised of spind-led/fascicular cells with moderate to severe pleomorphism and focal necrosis.The mitotic index was greater than 20 mitoses per 10 high-power fields.The resection margins were free of tumor.Immunohistochemistry(IHC)depicted a desmin-positive/caldesmon-negative/discovered on gastrointestinal stromal tumor 1-negative/cluster of differentiation 117-negative profile,confirming the definitive diagnosis as PHL.CONCLUSION This case report highlights the rare malignant mesenchymal hepatic tumor.To confirm PHL diagnosis,one requires peculiar histopathological findings with ancillary IHC confirmation.Management options include adequate/complete sur

关 键 词：LEIOMYOSARCOMA IMMUNOHISTOCHEMISTRY HEPATECTOMY Surgical resection Case Report 

分 类 号：R735.7[医药卫生—肿瘤]