# 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.

## Key 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.