Wu FN, Zhang M, Zhang K, Lv XL, Guo JQ, Tu CY, Zhou QY. Primary hepatic leiomyosarcoma masquerading as liver abscess: A case report. World J Gastrointest Surg 2024; 16(11): 3598-3605 [DOI: 10.4240/wjgs.v16.i11.3598]
Corresponding Author of This Article
Qing-Yun Zhou, MMed, Occupational Physician, Department of Hepatobiliary and Pancreatic Surgery, Lishui Municipal Central Hospital, No. 289 Kuocang Road, Lishui 323000, Zhejiang Province, China. zhou08wu@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Nov 27, 2024; 16(11): 3598-3605 Published online Nov 27, 2024. doi: 10.4240/wjgs.v16.i11.3598
Primary hepatic leiomyosarcoma masquerading as liver abscess: A case report
Fang-Nan Wu, Min Zhang, Kun Zhang, Xin-Liang Lv, Jing-Qiang Guo, Chao-Yong Tu, Qing-Yun Zhou
Fang-Nan Wu, Kun Zhang, Xin-Liang Lv, Jing-Qiang Guo, Qing-Yun Zhou, Department of Hepatobiliary and Pancreatic Surgery, Lishui Municipal Central Hospital, Lishui 323000, Zhejiang Province, China
Min Zhang, Department of Pathology, Lishui Municipal Central Hospital, Lishui 323000, Zhejiang Province, China
Chao-Yong Tu, Department of Hepatobiliary and Pancreatic Surgery, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui 323000, Zhejiang Province, China
Co-corresponding authors: Chao-Yong Tu and Qing-Yun Zhou.
Author contributions: Tu CY and Zhou QY contributed equally to the manuscript; Tu CY and Zhou QY designed the study, they are the co-corresponding authors of this article; Wu FN completed the first draft of this manuscript and performed the experiments and data collection; Zhang K, Lv XL, and Guo JQ were involved in data collection; Zhang M provided pathological findings; Zhou QY revised the manuscript. All authors have read and approved the final version of the manuscript.
Supported bythe Lishui City Key Research and Development Project, No. 2022ZDYF08.
Informed consent statement: The patient and his family provided their written informed consent and agreed to the publication of this case report.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qing-Yun Zhou, MMed, Occupational Physician, Department of Hepatobiliary and Pancreatic Surgery, Lishui Municipal Central Hospital, No. 289 Kuocang Road, Lishui 323000, Zhejiang Province, China. zhou08wu@163.com
Received: July 30, 2024 Revised: September 19, 2024 Accepted: October 12, 2024 Published online: November 27, 2024 Processing time: 92 Days and 12.6 Hours
Abstract
BACKGROUND
Primary hepatic leiomyosarcoma (PHL) is a rare malignant tumor and has non-specific clinical manifestations and imaging characteristics, making preoperative diagnosis challenging. Here, we report a case of PHL presenting primarily with fever, with computed tomography imaging showing a thick-walled hepatic lesion with low-density areas, resembling liver abscess.
CASE SUMMARY
The patient was a 34-year-old woman who presented with right upper abdominal pain and fever over 4 days before admission. Based on the patient’s medical history, laboratory examinations, and imaging examinations, liver abscess was suspected. Mesenchymal tumor was diagnosed by percutaneous liverbiopsy and partial hepatectomy was performed. Postoperative pathology revealed PHL. The patient is currently undergoing intravenous chemotherapy with the AD regimen and shows no signs of recurrence.
CONCLUSION
When there is a thick wall and rich blood supply in the hepatic lesion with a large proportion of uneven low-density areas, PHL should be considered.
Core Tip: Primary hepatic leiomyosarcoma (PHL) is a rare malignant tumor and has non-specific clinical symptoms and imaging manifestations, and patients have a poor prognosis. Our patient was characterized by fever and a thick-walled cystic lesion, leading to our primary diagnosis of liver abscess. When a computed tomography scan shows the presence of a thick wall and rich blood supply in the hepatic lesion with a large proportion of uneven low-density areas, the possibility of PHL should be considered. Magnetic resonance imaging and biopsy can provide the assessment and diagnosis. If conditions allow, early radical surgery is the most effective treatment. In-depth studies are needed to find effective treatments for unresectable PHL.
