Leiomyosarcoma metastatic to the liver: CT appearance

Leiomyosarcoma is an uncommon malignancy that metastasizes to the liver and lungs. Each of the three cases of leiomyosarcoma metastatic to the liver examined by computed tomography demonstrated similar morphologic and dynamic characteristics. Common features included hepatomegaly and large, circumscribed "cannonball" lesions that distorted normal hempatic architecture. These larger metastases were sharply defined with central necrosis and were accentuated by contrast enhancement of normal surrounding liver. Smaller perfused metastases often became isodense following contrast medium administration. This combination of features and effects should alert one to the possible diagnosis of metastatic leiomyosarcoma and cautions against underestimating the extent of disease by having precontrast control scans for comparison.