Hepatocellular Carcinoma with sarcomatous change

Hepatocellular carcinoma (HCC) with sarcomatous change is an uncommon neoplasm with a poor prognosis. To report a new case. A 72-year-old man presented with abdominal right upper quadrant pain. The diagnosis of cirrhosis was suspected on clinical and biochemical data. On abdominal computed tomography, the mass was not enhanced in the arterial phase and exhibited peripheral enhancement during portal phase which persisted in the delayed phase. The serum alpha-fetoprotein was 500 ng/ml but since the imaging features were not typical of ordinary HCC, percutaneous liver biopsy was performed and confirmed the diagnosis of HCC with sarcomatous change. Except for liver biopsy, no diagnostic method could distinguish between sarcomatous and ordinary HCC.