Primary Hepatic Leiomyosarcoma Presenting as a Multiloculated Cystic Mass: A Case Report and Review of Literature

TL;DR

A rare liver cancer called primary hepatic leiomyosarcoma was misdiagnosed as an abscess due to its unusual cystic appearance.

Contribution

This case report highlights the rare cystic presentation of primary hepatic leiomyosarcoma.

Findings

The patient's liver mass was initially suspected to be a hepatic abscess but was confirmed as PHL via histopathology.

The patient's condition progressed rapidly despite palliative chemotherapy.

The case emphasizes the need for a broad differential diagnosis in hepatic masses with atypical features.

Abstract

Primary hepatic leiomyosarcoma (PHL) is a rare malignant mesenchymal tumor representing a small fraction of primary hepatic cancers. Due to its nonspecific clinical and radiologic presentation, it is often misdiagnosed. We present the case of an 82-year-old male who presented with altered mental status and was found to have a multiloculated cystic mass in the liver, initially suspected to be a hepatic abscess. Histopathological evaluation of the mass revealed a diagnosis of PHL. Despite palliative chemotherapy, the patient succumbed to metastatic disease within two months. PHL is a rare neoplasm with varied clinical manifestations. The unusual cystic presentation, as seen in this case, highlights the importance of maintaining a broad differential when evaluating hepatic masses.

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