PMC4435293_01
CT scan of upper abdomen (axial and coronal sections) showing homogenously enhanced mass lesion of 14.9 x 12.9 cm in left lobe of liver, with multiple vascular structures traversing the lesion suggestive of hepatocellular carcinoma.
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F1
CT scan of the abdomen showed a homogenously enhancing mass lesion of 14.9 x 12.9 cm in the left lobe of the liver with multiple vascular structures traversing the lesion consistent with hepatocellular carcinoma (Figure 1).
Intraoperative picture showing tumor arising from inferior surface of left lobe of liver, adhered to stomach along lesser curvature.
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F2
Intraoperative examination revealed a 15 x 20-cm lesion arising from the inferior aspect of the left lateral segment of the liver, adhered to the stomach along the lesser curvature (Figure 2).
Excised specimen surrounded by capsule. Cut section showing myxoid stroma with areas of hemorrhagic necrosis.
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F3
Cut specimen showed solid tumor with cystic areas of hemorrhage and multiple vascular structures traversing the tumor (Figure 3).
(A) 100x picture showing normal liver in right upper part and tumor in the lower part. (B) 100x tumor showing mixture of highly atypical spindle and giant cells with sarcomatous appearance. (C) 400x large tumor giant cells with sarcoma-like appearance. (D) 400x vimentin positivity in tumor cells.
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F4
This suggested undifferntiated embryonal sarcoma of liver (USEL; Figure 4), a rare, highly malignant neoplasm that is more common in children.