Abstract
The present case report describes imaging findings (CT and MRI features) of a primary malignant fibrous hystiocitoma, presenting as a dual stage lesion, completely exophytic along liver surface with surgical and histological correlations. Imaging characteristics suggested the nature of the lesion (mesenchymal) and the behavior (expansile growth pattern) which addressed surgeons to a conservative excision.
Highlights
We present a case of primary malignant fibrous hystiocitoma (MFH) arising from liver glisson capsule, surgically confirmed
To the best of our knowledge, this is the first reported case that shows MFH arising from glisson capsule, with a growth pattern completely exophytic along liver surface
Malignant fibrous hystiocitoma represents a relatively ”young” pathological entity, as it was first described by Orien and Stout in 1964
Summary
We present a case of primary malignant fibrous hystiocitoma (MFH) arising from liver glisson capsule, surgically confirmed. Investigations Patient underwent CT examination with triphasic study, and underwent MRI examination after GD-DTPA e.v. administration Both the exams showed a large encapsulated lesion, between gallbladder fossa, Vth and IVth liver segments with a peduncolated cranial nodule in the liver hilum. According to imaging characteristics and laboratory markers radiologist suggested diagnosis of a huge liver encapsulated mesenchimal tumor arising from glisson capsule. This lesion showed a “two face” appearance, as the peduncolated nodule in the hilum, seemed to be the same lesion in an earlier stage of evolution, due to a more conspicuous enhancement and homogeneous hypointensity signal respect to the bigger more heterogeneous lesion (Figure 6). Alpha-fetoprotein at the last follow up were 14 (U/L), 16 (U/L) and 6 (ng/ml) respectively
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