伪装成肝脓肿的原发性肝平滑肌肉瘤：一例报告。
Primary hepatic leiomyosarcoma masquerading as liver abscess: A case report.
作者信息
Wu Fang-Nan, Zhang Min, Zhang Kun, Lv Xin-Liang, Guo Jing-Qiang, Tu Chao-Yong, Zhou Qing-Yun
机构信息
Department of Hepatobiliary and Pancreatic Surgery, Lishui Municipal Central Hospital, Lishui 323000, Zhejiang Province, China.
Department of Pathology, Lishui Municipal Central Hospital, Lishui 323000, Zhejiang Province, China.
出版信息
World J Gastrointest Surg. 2024 Nov 27;16(11):3598-3605. doi: 10.4240/wjgs.v16.i11.3598.
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.
背景
原发性肝平滑肌肉瘤（PHL）是一种罕见的恶性肿瘤，具有非特异性的临床表现和影像学特征，术前诊断具有挑战性。在此，我们报告一例主要以发热为表现的PHL病例，计算机断层扫描成像显示肝脏有一个厚壁病变，伴有低密度区域，类似肝脓肿。
病例摘要
患者为一名34岁女性，入院前4天出现右上腹疼痛和发热。根据患者的病史、实验室检查和影像学检查，怀疑为肝脓肿。经皮肝穿刺活检诊断为间叶性肿瘤，并进行了部分肝切除术。术后病理显示为PHL。患者目前正在接受AD方案的静脉化疗，未出现复发迹象。
结论
当肝脏病变有厚壁且血供丰富，同时有较大比例不均匀的低密度区域时，应考虑PHL。
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