Undifferentiated liver embryonal sarcoma in adults: A report of four cases and literature review

Figure 1 Abdominal ultrasonography showing a 16. 5 cm × 11.2 cm multilocular cystic liver mass (A), computed tomography imaging demonstrating a large, hypodense tumor occupying the right lobe of liver with multicystic (B) and solid portions (C), and polychromatic cut surface which is soft with fluid and mucoid zones, firm with fleshy areas and necrotico-hemorrhagic changes (D).

Figure 2 Histology showing residual hepatocytes and bile ducts in the tumor (A), giant cells containing eosinophilic hyaline globules in the cytoplasm (B), loose oedematous myxoid matrix with sparse stellate atypical mesenchymal cells (C), fibroblast-like fascicles (D), angiosarcoma-like cells (E) and pericytoma-like and rhabdomyosarcoma-like cells (F) in compact areas (HE, × 400).

Figure 3 Immunohistochemistry showing tumor cells strongly reactive to vimentin (A), diffuse membranous immunostaining for CD56 in mesenchymal cells (B), diffuse multifocal cytoplasmic immunostaining with a distinct paranuclear dot-like staining using cytokeratin 19 (C), focal cytoplasmic positivity for desmin in some tumor cells (D), tumor cells focally positive for α-smooth muscle actin (E) and S100 (F) (EnVision+, × 400).