A Successfully Resected Case of Undifferentiated Sarcoma of the Liver with Congestion of Hepatic Vein and Inferior Vena Cava

Takafumi Hirata, Toru Beppu, Takatosi Isiko, Shinichi Sugiyama, Hiroshi Takamori, Keiitirou Kanemitu, Yumi Honda¹⁾, Kenichi Sakurai²⁾, Masahiko Hirota and Hideo Baba

Department of Gastroenterological Surgery and Department of Surgical Pathology¹⁾, Kumamoto University
Department of Gastroenterology, Kumamoto Central Hospital²⁾

Undifferentiated sarcoma of the liver (USL) in adulthood is rare and has a dismal prognosis. We report a case of USL in a 52 year-old-woman, who had a huge tumor in the right hepatic lobe. She was admitted with a performance status of 3 after a 2-month episode of general fatigue and dyspnea. Laboratory data showed slight anemia and liver dysfunction, but other data was almost within normal limits. Diagnostic images revealed a huge cystic, degenerated tumor in the right hepatic lobe. The tumor was enhanced slightly but was mostly hypovascular in computed tomography. DSA showed the inferior vena cava, hepatic vein, and hepatic triad to be suppressed by tumor. Preoperative diagnoses were USL, hemangiosarcoma, or hepatic adenoma. Trisegmentectomy of the liver with an anterior approach was successful. The tumor weighed almost 4,000 g, over 20 cm. The cut surface of the resected tumor showed solid and liquid components with gelatinous material and coagulation. The tumor was stained strongly for Vimentin and partially for alpha SMA by immunohistochemical examination. The definitive diagnosis was hepatic USL. Postoperatively, She suffered from re-expansive pulmonary edema of the right lower lobe of lung, but recovered immediately. The patientremains alive with no recurrence or symptoms and PS of 0, 9 months after surgery.

Key words
undifferentiated sarcoma, liver, adult

Reprint requests
Takafumi Hirata Department of Gastroenterological Surgery, Kumamoto University
1-1-1 Honzyo, Kumamoto, 860-8556 JAPAN

Accepted
December 15, 2006

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