PMC9051403_01
(A) Abdominal enhanced computed tomography showing a 7.5*7.3*7.7 cm high-density mass lesion involving left hepatic lobe, tending to be malignant. (B) After percutaneous liver biopsy, H&E stained showed the lession was composed of numerous large and small round cells, haphazardly oriented, containing variable amount of cytoplasm and prominent nucleolus (40x). (C) Postoperative specimen revealed a 5.5*5.0*4.0 cm well-defined soft mass with a gray/yellowish/reddish brown cut surface, in which hemorrhage, necrosis and cystic lesion could be seen. (D) H&E stained of the tumor revealed typical rhabdomyoblasts (black arrow) with oval nucleus, median nucleolus and eosinophilic cytoplasm (40x).
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F1
Abdomen contrast-enhanced computed tomography scans showed a mass-like high-density shadow (7.5 x 7.3 x 7.7 cm) in the left lobe of the liver, next to the lesser curvature of the stomach (Figure 1A). He underwent percutaneous liver biopsy, and histopathological examination of the tumor cells displayed large and small round cells, haphazardly oriented, containing variable amount of cytoplasm and prominent nucleolus (Figure 1B). The gross specimen revealed a well-defined tenacious texture mass (5.5 x 5.0 x 4.0 cm; Figure 1C). Postoperative histopathological evaluation demonstrated typical rhabdomyoblasts with oval nuclei, median nucleoli, and eosinophilic cytoplasm (Figure 1D).
Immunohistochemical stains showing tumor cells (A) desmin positive; (B) myogenin positive. Myogenin is highly specific and sensitive for rhabdomyosarcoma, which currently used as the standard antibody for diagnosis.
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F2
Immunohistochemical analysis (Figure 2) was positive for vimentin, desmin, and myogenin and focally positive for smooth muscle actin.
Imaging findings during follow up: there was no abnormal density shadow in the liver, which was consistent with the changes of hepatic caudate lobe resection. (A) abdominal computed tomography of the abdomen 2 months after the surgery; (B) Enhanced computed tomography of the abdomen 14 months after the surgery.
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F3
Regarding the prognosis, the patient survives for 38 months since first being accepted to the hospital, and to date, no recurrence or metastasis has been found by abdominal computed tomography or abdominal ultrasound after treatment (Figure 3).