Clinical features and spiral computed tomography analysis of undifferentiated embryonic liver sarcoma in adults.

OBJECTIVE

To summarize the clinical and spiral computed tomography (CT) features of undifferentiated embryonic liver sarcoma (UELS) in adults.

METHODS

Clinical and CT findings of four adult patients with pathology-approved UELS were retrospectively analyzed with a literature review. All patients were examined using a plain and enhanced spiral CT scan.

RESULTS

The participants were two men and two women with a mean age of 36.5 years. The clinical manifestations were the right upper quadrant mass, pain (n = four) and intermittent fever (n = three). Laboratory tests showed a mild elevation of alpha-fetoprotein in one patient and mildly abnormal liver function in two. Liver cirrhosis was present in one patient coexistent with hepatocellular carcinoma. CT findings indicated a huge well-defined cystic-solid mass with varying degrees of enhancement of the solid component. Irregular high-density lesions showing hemorrhage occurred in three patients and the inferior vena cava was compressed in one.

CONCLUSION

UELS showed a solitary and predominantly cystic or multicystic appearance on CT imaging compared with ultrasound (US) from the medical literature, which shows a predominantly hypoechoic mass. The laboratory tests were normal or mildly abnormal despite the presence of the large mass. The combination of these clinical features and CT findings together with those of US are helpful in making a prospective diagnosis.