Case Report
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 14, 2017; 23(38): 7054-7058
Published online Oct 14, 2017. doi: 10.3748/wjg.v23.i38.7054
High-grade myofibroblastic sarcoma in the liver: A case report
Jun Wen, Wei Zhao, Chuan Li, Jun-Yi Shen, Tian-Fu Wen
Jun Wen, Chuan Li, Jun-Yi Shen, Tian-Fu Wen, Department of Liver Surgery and Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Jun Wen, Department of General Surgery, The Third People’s Hospital of Chengdu, Chengdu 610031, Sichuan Province, China
Wei Zhao, Department of Pathology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Wen J collected the clinical data, searched the relevant literature, and wrote the paper; Li C, Shen JY ,Wen TF performed the surgical operation; Zhao W performed the pathological diagnosis; Wen TF approved the final manuscript version to be submitted.
Institutional review board statement: This study was approved by West China Hospital Ethics Committee, Chengdu, China.
Informed consent statement: The patient in this study provided written informed consent prior to the manuscript preparation.
Conflict-of-interest statement: The authors declare no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Tian-Fu Wen, MD, Director, Department of Liver Surgery and Liver Transplantation Center, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu 610041, Sichuan Province, China. cdwentianfu@126.com
Telephone: +86-28-85422867 Fax:+86-28-85422867
Received: April 23, 2017
Peer-review started: April 25, 2017
First decision: May 12, 2017
Revised: June 18, 2017
Accepted: August 15, 2017
Article in press: August 15, 2017
Published online: October 14, 2017
Abstract

Only two cases of myofibroblastic sarcoma in the liver have been reported in the literature. Here, we report the case of a male patient with high-grade myofibroblastic sarcoma mimicking echinococcosis in the liver. The 25-year-old male patient complained of right upper quadrant swelling pain for one week and was initially diagnosed with echinococcosis. He was then scheduled for an exploratory laparotomy. During the operation, a huge mass exceeding 16 cm in diameter was found to occupy nearly the entire right trisegment of the liver, with a clear boundary and a round shape, and the mass was resected by right hepatic trisegmentectomy. Immunohistochemical staining revealed that the tumor tissue was positive for desmin, α-smooth muscle actin, CD56, and vimentin and negative for ALK-1, myogenin, calponin, β-catenin, S100, and glypican-3, with a Ki-67 (MIB-1) index of approximately 20%. Based on the histological manifestations and immunohistochemical staining, a diagnosis of myofibroblastic sarcoma was established. The postoperative recovery was uneventful. There was no evidence of recurrence or metastasis through the last follow-up, 6 mo after surgery, despite a lack of postoperative chemotherapy or radiotherapy. To the best of our knowledge, the present case is the first reported case of high-grade myofibroblastic sarcoma in the liver, and it is also the first reported case in a male patient.

Keywords: Myofibroblastic sarcoma, Liver, High-grade, Male, Immunohistochemical staining

Core tip: The development of myofibroblastic sarcoma in the liver is exceedingly rare. We present a case of high-grade myofibroblastic sarcoma in a male patient. The 25-year-old male patient complained of right upper quadrant swelling pain for one week and was diagnosed with high-grade myofibroblastic sarcoma after right hepatic trisegmentectomy based on the histological manifestations and immunohistochemical staining. There was no evidence of recurrence or metastasis through the last follow-up, 6 mo after surgery, despite a lack of postoperative chemotherapy or radiotherapy. The case presented is the first reported case of high-grade myofibroblastic sarcoma in the liver.