A Case of Primary Hepatic Leiomyoma Developed in Healthy Patient

Abstract

Introduction: Primary hepatic leiomyoma(PHL) is very rare, benign tumors developed from the smooth muscle of the vessel or bile duct. It can be more observed in patients with immune suppression or organ transplantation. Because of the rareness of disease, the preoperative diagnosis of PHL is often difficult. Methods: A 42-year-old woman was referred to our hospital for further evaluation of hepatic mass detected during routine screening examination. The patient was asymptomatic and had no history of liver disease, heavy alcohol consumption, or oral contraceptive usage. All the routine laboratory tests including tumor markers were within normal ranges. Abdominal CT demonstrated 7.4 x 7.1 cm sized well-defined mass in inferior portion of left liver that showed heterogenous enhancement in arterial phase, homogenous and delayed enhancement in delayed phase. In liver MRI, the mass showed low signal intensity on T1 and T2 weighted images. Results: In laparotomy, 8 x 6 x 6 cm size tumor arised from the caudate lobe of the liver was found. We performed caudate lobe wedge resection including tumor with clear surgical margin. Microscopically, the tumor is composed of bland-looking spindle cells with whirling pattern. Immunohistochemical staining was positive for Actin, Desmin, Vimentin, Caldesmon and negative for CD34, C-kit, CK, S-100, HMB-45, EMA. Pathologically, the tumor was identified as PHL. Conclusion: PHL is a rare neoplasm and it should be considered differential diagnosis of other liver tumors. Herein, we report a case of PHL developed in healthy patient.