Undifferentiated Embryonal Sarcoma of the Liver

A 45-year-old male presented with upper abdominal pain that began 1 week ago, described as intermittent and dull. Physical examination revealed tenderness in the upper abdomen. The liver was palpable 10 cm below the right midclavicular line at the costal margin. Laboratory tests showed no significant abnormalities. The computed tomography image is shown in Figure 1a. The patient underwent right hemihepatectomy with caudate lobe resection. Histopathological findings are illustrated in Figure 1b. The diagnosis was a malignant tumor with necrosis, consistent with an undifferentiated sarcoma of the liver (UESL). During a 6-month follow-up, tumor metastasis was noted in the gastrointestinal space, along with multiple masses in the anterior left lobe of the liver and right renal space, indicating tumor recurrence. Dynamic axial contrast-enhanced CT scans showing mild heterogeneous enhancement of these lesions.

UESL, is an exceedingly rare malignant liver tumor. UESL ranks third in children, with adult occurrences being particularly uncommon.

Due to the rarity of UESL, imaging features lack specificity. CT scans revealed solid components often reside at the tumor margins with irregular septations and hemorrhage. Contrast-enhanced scans may demonstrate fast in fast out enhancement or delayed enhancement patterns. This case lacks typical imaging manifestations of enhancement, showing mild heterogeneous enhancement, which may be related to extensive hemorrhage and necrosis.

Lingqing Tang: writing – original draft (lead), resources (equal). Bin Yang: resources (equal), writing – review and editing (lead).

The authors have nothing to report.

The patient has provided written informed consent prior to taking part in this study.

The authors declare no conflicts of interest.