Primary Hepatic Leiomyosarcoma A Space Occupying Lesion in the Liver: An Enigma for Diagnosis

More, Rajdeep B; Shera, Irfan Ali; Patel, Sitendu Kumar; Setya, Ashwini Kumar; Raj, Vivek

doi:10.15226/2374-815x/4/5/001102

Cited by 1 publication

(3 citation statements)

References 7 publications

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“…Although no literature demonstrated a relationship between the two. 4,5 The absence of specific tumour markers also makes diagnosing this disease difficult. 5 CT-scan examination revealed irregular solid heterogeneity and border in segments 1 and 4b of the liver.…”

Section: Discussionmentioning

confidence: 99%

“…4,5 The absence of specific tumour markers also makes diagnosing this disease difficult. 5 CT-scan examination revealed irregular solid heterogeneity and border in segments 1 and 4b of the liver. Furthermore, post-contrast showed slight contrast enhancement narrowing the bilateral IHBD and tumoral thrombus in the inferior vena cava.…”

Section: Discussionmentioning

confidence: 99%

“…PHL's CT-scan finding is usually heterogeneous and sometimes accompanied by imaging resembling a liver cyst or liver abscess.3 These findings are consistent with a previous case report. 5 The primary diagnosis is established by eliminating other major organ causes, such as the genitourinary, retroperitoneal, and gastrointestinal tract. 4 In this case, no malignancy was found elsewhere.…”

Section: Discussionmentioning

confidence: 99%

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A rare primary liver tumour case report: 53-year-old man with primary hepatic leiomyosarcoma

Pramana

Kusnanto

Darmayani

et al. 2022

JKKI

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Primary hepatic leiomyosarcoma (PHL) is a very rare primary liver tumour. These tumours usually arise from intrahepatic vascular structures, gallbladder, or ligamentum teres. The pathogenesis of this disease is still unknown. We report a 53-year-old man with complaints of intermittent right upper abdominal pain for one month, decreased appetite, nausea, weight loss, and tea-coloured urination. The patient denied any complaints of defecation pattern. On physical examination, jaundice was present in both eyes and the whole-body skin, tenderness in the right hypochondriacal region, and enlarged liver with a lumpy surface. The laboratory examination demonstrated increased transaminase enzymes and bilirubin, while hepatitis B and C were negative. The patient underwent several tests for tumour markers, such as CA 19-9 50 (<37 U/mL), AFP 1.23 (<5.81 IU/mL), and CEA 0.83 (<3 ng/mL). Ultrasound demonstrated an enlarged liver, multiple liver nodules, and cholelithiasis. Meanwhile, the abdomen’s computerised tomography (CT) scan shows a solid heterogeneity image with an irregular border in segments 1 and 4b and a tumoral thrombus in the inferior vena cava. The diagnosis was confirmed by biopsy and immunohistochemistry (IHC); vimentin and smooth muscle actin (SMA) results were positive, while CD 34, CD 117, and cytokeratin were negative. Our patient was diagnosed with PHL stage IVa (T4N2M0). PHL is a particularly rare tumour with a poor prognosis. The patient died after one month of diagnosis. Diagnosis of PHL is challenging. It was based on clinical features, physical examinations, laboratory examinations, and other supporting investigations.

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Section: Discussionmentioning

confidence: 99%