Primary Hepatic Leiomyosarcoma: Case Report and Literature Review

Introduction: Primary hepatic leiomyosarcoma (PHL) is an extremely rare tumor, accounting for 0.2–2% of all primary malignancies, with less than 70 cases reported worldwide. Herein, we report a case 48-year-old female patient large surgically resected PHL. Case presentation: Forty eight year old woman known diabetic, hypertensive and morbidly obese presented in clinic upper abdominal pain weight loss, without any history fever, jaundice liver disease. Computed tomography revealed ill-defined heterogeneous contrast enhancing hyper vascular mass 9.9 x 7.8 cm involving left lobe central necrosis patchy partial washout on delayed images compressing the vein evidence cirrhosis SUV 6.4 PET-CT scan. USG guided biopsy smooth muscle neoplasm, consistent Leiomysocarcoma. After optimization co morbidities Left hepatectomy was performed. Tumor free resection margins were achieved. Pathological findings nodular whorled white appearing tumor comprised spindled/fascicular cells moderate to severe pleomorphism necrosis. Mitotic index >20 mitoses per 10 HPFs. Immunohistochemistry stains DOG1: Negative confirming final diagnosis Hepatic leiomyosarcoma. Postoperative course uneventful, she discharged 6th postoperative day. Conclusions: PHL malignant disease relatively poor prognosis. To confirm PHL, immunohistochemical analysis as well histopathological important. The preferred treatment surgical resection.