Primary hepatic sarcomas: CT findings

Yu, Ri‐Sheng; Chen, Ying; Jiang, Biao; Wang, Liu-Hong; Xu, Xiufang

doi:10.1007/s00330-008-0997-7

Cited by 76 publications

(53 citation statements)

References 49 publications

(102 reference statements)

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“…Although sporadic cases with delayed contrast-enhancing hepatic localised fibrous tumour have been reported, large quantities of calcifications within the mass and a delayed enhancing pattern of CFT was somewhat different from the usual hepatic localised fibrous tumour [15]. Other malignant mesenchymal sarcomas such as MFH, chondrosarcoma and carcinosarcoma can sometimes show tumoural calcifications, but these lesions usually show more indistinct margins and larger cystic or necrotic changes, suggesting their aggressiveness [16,17]. Most reported hepatic inflammatory pseudotumours (IPTs) have been hypovascular, with scarce enhancement at the arterial phase, and this could present a dilemma in the differential diagnosis between CFT and IPT.…”

Section: Discussionmentioning

confidence: 94%

Imaging findings of calcifying fibrous tumour of the liver

Bj¹,

Sw²,

Ahn³

et al. 2011

BJR

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ABSTRACT. Calcifying fibrous tumour (CFT) is a recently recognised rare benign lesion characterised by dense hyalinised collagenous tissue, psammomatous or dystrophic calcifications and a lymphoplasmacytic infiltrate. The usual locations of the lesion are the soft tissues of the extremities, but rarely it occurs in the abdomen. Recently, we experienced a case of CFT found in the liver of a 29-year-old woman. Here, we describe the characteristic radiological and histopathological findings, along with a review of the relevant literature. Calcifying fibrous tumour (CFT) is a recently recognised rare benign lesion characterised by dense hyalinised collagenous tissue interspersed with benign spindle cells, psammomatous or dystrophic calcifications and a lymphoplasmacytic infiltrate. To date, fewer than 80 cases have been reported in the literature. Usually, these tumours occur in the soft tissues of the extremities and trunk, followed by the neck, axilla and pleura. Rare sporadic cases have been reported, with the tumour occurring in various anatomical sites such as the groin, scrotum, adrenal gland, breast, peritoneum and mesentery [1][2][3][4][5][6][7][8][9].We present a case of a CFT found in the liver and describe the characteristic radiological and histopathological findings, along with a review of the relevant literature. Case reportA 29-year-old woman was admitted to our hospital because of a palpable mass on the right upper quadrant of the abdomen that had been present for 3 weeks. She had given birth approximately 3 months previously and her medical history was unremarkable. On physical examination, a hard mass was palpable on the right upper quadrant of the abdomen and there was minimal tenderness. Viral markers for hepatitis and the level of tumour markers such as serum a-fetoprotein and carcinoembryonic antigen were within normal limits. Other laboratory findings were also normal.The patient underwent a helical CT scan (Somatom Plus 32, Siemens Medical Systems, Erlangen, Germany) of the liver. Contrast-enhanced dynamic CT revealed a 10 6 10 cm solid mass in segments V and VI of the right lobe of the liver. The mass was well demarcated and showed an exophytic growth pattern. On pre-contrast images, multiple laminated and amorphous calcifications were detected within the mass. After iv injection of contrast material, the mass was slowly enhanced. On 4 min delayed images, a large portion of the mass was enhanced (Figure 1). Liver MRI (1.5 T Magnetom Vision, Siemens Medical Systems) was performed for further evaluation of the mass 4 days after the CT scan. The mass showed as dark signal intensity on T 2 weighted images and slightly low signal intensity on T 1 weighted images. The contrast enhancement pattern on MRI was the same as with the CT scan (Figure 2). Ultrasound study of the abdomen showed severe posterior acoustic shadowing from the anterior portion of the mass, owing to dense calcifications. The mass could not be penetrated by an 18-gauge biopsy needle because of hardness from calcification. Consequ...

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Section: Discussionmentioning

confidence: 94%

Imaging findings of calcifying fibrous tumour of the liver

Bj¹,

Sw²,

Ahn³

et al. 2011

BJR

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“…Since the first report in 1985, only about 30 cases of hepatic MFH have been reported in the English literature [17][18][19][20] . There is no predilection for lobe or the site of origin.…”

Section: Liver Mfhmentioning

confidence: 99%

“…Smaller tumors may show a solid mass without prominent internal necrosis [21] . Following contrast injection, heterogeneous mild to moderate enhancement of the mass with several necrotic areas may be evident, and rarely enhancing peripheral pseudo-capsule or significant enhancement is noted [17] . Although the vascularity of MFH is variable, the majority of lesions are moderately hypervascular with the tumor supply derived from multiple surrounding vessels [23] .…”

Section: Liver Mfhmentioning

confidence: 99%

“…The patient with a mass in the left liver lobe showed a poorly demarcated tumor margin (Figure 3), while the other two had well demarcated margins. The tumors may involve the liver capsule and adjacent organs, but there is no evidence of portal vein invasion, bile duct obstruction, or regional lymph node metastasis [17,21] . A report of a mass undergoing complete necrosis and significant intratumoral hemorrhage involving the hemoperitoneum has also been published [23] .…”

Section: Liver Mfhmentioning

confidence: 99%

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Primary malignant fibrous histiocytoma of the abdominal cavity: CT findings and pathological correlation

Karki

Xu²,

Wu³

et al. 2012

WJR

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AIM:To study computed tomography (CT) �eatures of abdominal malignant fibrous histiocytoma (MFH) in various rare locations. METHODS:We retroprospectively identi�ied cases o� �FH involving the abdominal cavity. �articular attention was paid to details regarding imaging �eatures and histological types. RESULTS:The study population consisted o� seven men and one woman, with a mean age o� 52.5 years. Seven patients had some physical symptoms, while one was incidentally detected. The sites o� origin were liver (n = 3), greater omentum (n = 1), superior mesentery (n = 1), ileum (n = 1), right psoas muscle (n = 1) and right kidney (n = 1). With the exception o� the ileum lesion, all were o� huge size. The contour o� the lesions was more or less clear. Foci o� necrosis were present in six lesions (n = 6). On plain CT scan, all lesions were hypo to iso dense. The lesion in the greater omentum was cystic. One lesion (n = 1) showed signi�icant enhancement and the cystic lesion showed mild peripheral enhancement. An abundance o� blood vessels surrounding the mass was seen in two lesions (n = 2) and both were o� the in�lammatory variety. �athological examination revealed stori�orm-pleomorphic variety (n = 4), inflammatory variety (n = 3) and myxoid variety (n = 1). Two of the patients with inflammatory MFH had a clinical presentation o� �ever and one was a�ebrile, however, blood investigations in all three showed leukocytosis.CONCLUSION: �rimary �FHs o� the abdominal viscera and gastrointestinal tract are generally huge so�t tissue masses containing areas o� low attenuation and mild to moderate contrast enhancement.

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“…5 Although hepatic tumors reveal a wide spectrum of calcification, 6 dense calcification on CT is rare and may be a specific finding of hepatic carcinosarcoma. 7,8 Some radiologists report that hepatocellular carcinoma with sarcomatous change did not enhance in the early phase on CT. 9,10 In our case, the carcinosarcoma revealed an area of hypointensity on contrast-enhanced CT and enhancement of a part of the tumor in the early phase. These findings were not definitive but, in addition to dense calcification, may aid diagnosis of hepatic carcinoma on CT.…”

Section: Discussionmentioning

confidence: 99%

MR Imaging of Carcinosarcoma of the Liver using Gd-EOB-DTPA

et al. 2014

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We present a case of a 69-year-old man with primary hepatic carcinosarcoma who underwent computed tomography that revealed a hypervascular hepatic tumor with local dense calcification. Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging revealed hyperintense lesions in the hepatobiliary phase that indicated hepatocellular carcinoma with bile production. The patient underwent right lobectomy, and the presence of a sarcoma component within the tumor on histopathology confirmed liver carcinosarcoma that included hepatocellular carcinoma. In cases with atypical images that resemble this case, the hyperintensity of a lesion in the hepatobiliary phase aids differential diagnosis.

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Primary hepatic sarcomas: CT findings

Cited by 76 publications

References 49 publications

Imaging findings of calcifying fibrous tumour of the liver

Imaging findings of calcifying fibrous tumour of the liver

Primary malignant fibrous histiocytoma of the abdominal cavity: CT findings and pathological correlation

MR Imaging of Carcinosarcoma of the Liver using Gd-EOB-DTPA

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