AJR:190, April 2008 W261
lization was not performed because of the
hypovascularity of the tumor. The patient
underwent surgical excision of the hepatic
mass. The pathologic finding was undiffer-
entiated embryonal sarcoma composed of
cystic areas with necrotic debris, hemorrhag-
ic fluid, clotted blood, gelatinous material,
and solid components with high mitotic ac-
tivity (Figs. 1C and 1D). The results of im-
munohistochemical staining were positive
for vimentin, desmin, and actin and negative
for CD117.
First described by Stocker and Ishak [1] in
1978, undifferentiated embryonal sarcoma is a
rare malignant hepatic neoplasm that most fre-
quently affects children between the ages of 6
and 10 years; it is uncommon in adults [1, 2].
Undifferentiated Embryonal
Sarcoma of the Liver
Michael Kim
1
Bethany Tireno
2
Priscilla J. Slanetz
3
Kim M, Tireno B, Slanetz PJ
1
Boston University School of Medicine, Boston, MA.
2
Department of Pathology, Boston University Medical
Center, Boston, MA.
3
Belkin Breast Imaging Center, Department of Radiology,
Boston University School of Medicine and Boston
Medical Center, 830 Harrison Ave., Boston, MA 02118.
Address correspondence to P. J. Slanetz
(Priscilla.Slanetz@bmc.org).
HepatobiliaryImaging•Radiologic–PathologicConferencesof
BostonUniversityMedicalCenter
WEB
This is a Web exclusive article.
AJR 2008; 190:W261–W262
0361–803X/08/1904–W261
© American Roentgen Ray Society
A
44-year-old woman presented
with a 1-year history of increas-
ing right upper quadrant pain
and fullness, fatigue, decreased
appetite, 50-lb (23 kg) weight loss, and inter-
mittent fevers. Serum laboratory values were
notable only for an elevated α-fetoprotein
level of 24.9 ng/mL (normal, 0–8.0 ng/mL).
Sonography revealed a 13-cm complex mul-
ticystic hypovascular mass situated between
the liver and the kidney (Fig. 1A). Abdomi-
nal CT and MRI findings confirmed the
presence of a 15-cm heterogeneous predomi-
nantly cystic mass with peripheral nodularity
in the right hepatic lobe (Fig. 1B). Preopera-
tive hepatic arteriography showed vascular
supply from the right hepatic artery. Embo-
Keywords: abdominal MRI, abdominal sonography,
hepatic sarcoma
DOI:10.2214/AJR.07.3058
Received August 23, 2007; accepted after revision
October 21, 2007.
Fig. 1—44-year-old woman with undifferentiated embryonal sarcoma of liver.
A, Sonogram of right upper quadrant shows 13-cm complex multicystic hypovascular mass situated between
liver and kidney.
B, Coronal single-shot T2-weighted MR image shows 15-cm heterogeneous predominantly multiseptate cystic
mass with peripheral nodularity (arrows) in right hepatic lobe.
(Fig. 1 continues on next page)
A B
Kim et al.
Sarcoma of Liver
Hepatobiliary Imaging
Radiologic–Pathologic Conferences of
Boston University Medical Center
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