A Case of Primary Leiomyosarcoma of the Liver

A case of primary leiomyosarcoma of the liver in a 65-year-old man is reported. The results of laboratory studies including α-fetoprotein were within normal limits except for a slightly elevated serum level of CEA (5.9ng/ml). Ultrasonography demonstrated a sharply marginated, round hypoechoic lesion in hepatic segments IV and V, which was 5.5×4.2 cm in diameter. The plain CT scan demonstrated a hypodense mass in the right lobe. During portovenous contrast medium distribution, peripheral enhancement and capsular structures appeared, accenting the capsular structures. Because malignant hepatic tumor was suspected preoperatively, and S5S4 segmentectomy was done. At histological study (including immunohistological study), the lesion was revealed to be leiomyosarcoma with many mitotic figures and micro-capsular invasion. Postoperative gallium scintigraphy showed no abnormal lesion. The diagnosis of primary leiomyosarcoma of the liver was made.