Undifferentiated embryonal sarcoma masquerading as liver abscess: A case report with typical imaging features

Abstract

Undifferentiated embryonal sarcoma (UES) is an uncommon paediatric hepatic tumour that clinically simulates a liver abscess when present with fever. This report describes a case of UES in a 12-year-old boy, who presented with abdominal pain, swelling and fever, all simulating a liver abscess. The possibility of UES was considered at imaging, based on the solid appearance on ultrasound and cystic appearance with serpiginous peripheral vessels on computed tomography/magnetic resonance imaging. The diagnosis was confirmed at histopathology.

Case Report of Undifferentiated Hepatic Embryonal Sarcoma with Mesenchymal Hamartoma: A Rare Entity

“…Hemorrhagic ascites or perihepatic fluid may be seen in cases of tumor rupture. 8 UES can coexist with mesenchymal hamartoma or can arise from preexisting mesenchymal hamartoma when these two entities are seen together on histopathology as in our case.…”

“…Sometimes lactate dehydrogenase levels can be elevated due to unknown reasons. 8 The imaging appearance of UES are nonspecific, varies from solid-to-solid cystic lesions with variable cystic contents. The lesion can have a paradoxical appearance in USG and CT. On USG, UES is mostly a solid-dominant mixed echogenic mass with variable cystic areas and septation; however, it often appears as a cystic lesion with low attenuation on CT and magnetic resonance.…”