Undifferentiated embryonal sarcoma of the liver in an adult: Case report and literature review

摘要

Undifferentiated embryonal sarcoma of the liver often presents in the childhood. Its occurrence rate in adults is extremely low. A 70-year-old woman suffered from right upper quadrant abdominal pain, fever, and body weight loss of 10 kg over half a year. Abdominal ultrasonography and computed tomography revealed one 9-cm tumor with a cystic component at S6/S7 of the liver. The tumor markers, such as serum alpha-fetoprotein, carcinoembryonic antigen, and carbohydrate antigen 19-9, were in the normal range. Repeated biopsies showed no malignancy. After exclusion of infectious diseases through an inflammation scan, she underwent S6/7 bisegmen-tectomy. The final report of pathology was undifferentiated embryonal sarcoma. No evidence of recurrence or metastases was noted dining follow-up visits. The rate of misdiagnosis before operation is high. The enhancing of radiological feature-reading skills and clinical awareness are considered to be necessary to reduce misdiagnosis. The prognosis was considered to be poor before. Multimodal treatment with complete surgical excision and chemotherapy provided the best chance of long-term disease-free survival. We concluded that undifferentiated embryonal sarcoma should be included in the differential diagnostic list of malignant liver tumors in adults.