Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 26, 2019; 7(4): 525-531
Published online Feb 26, 2019. doi: 10.12998/wjcc.v7.i4.525
Primary hepatic leiomyosarcoma successfully treated by transcatheter arterial chemoembolization: A case report
Ke-Lei Zhu, Xiu-Jun Cai
Ke-Lei Zhu, Xiu-Jun Cai, Department of General Surgery, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou 310016, Zhejiang Province, China
Ke-Lei Zhu, Department of Hepatobiliary Surgery, Yinzhou People’s Hospital, Ningbo 315040, Zhejiang Province, China
Author contributions: Zhu KL and Cai XJ solely contributed to this paper.
Supported by Yinzhou Young Investigator Award, NO. Yin Ren She 2017-133; and Ministry of Science of Yinzhou District, No. Yin Ke 2017-110.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of Sir Run Run Shaw Hospital, Hangzhou, China.
Informed consent statement: The patient described in the case report gave verbal consent for anonymous description of the case.
Conflict-of-interest statement: None of the authors have any conflict of interest to declare.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
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/
Corresponding author: Xiu-Jun Cai, FRSC, PhD, Professor, Surgeon, Department of General Surgery, Sir Run Run Shaw Hospital, Zhejiang University, No. 3, Qingchun East Road, Hangzhou 310016, Zhejiang Province, China. cxjzu@zju.edu.cn
Telephone: +86-571-86006605
Received: October 10, 2018
Peer-review started: October 10, 2018
First decision: November 27, 2018
Revised: December 22, 2018
Accepted: December 29, 2018
Article in press: December 30, 2018
Published online: February 26, 2019
Processing time: 139 Days and 19 Hours
Abstract
BACKGROUND

Primary hepatic leiomyosarcoma is rare and reported sporadically, with less than 40 such cases have been reported in the English-language literature. Although it is reported to be associated with acquired immune deficiency syndrome, Epstein-Barr virus infection, Hodgkin’s lymphoma, immunosuppression after organ transplantation, and hepatitis C virus-related liver cirrhosis, the precise steps leading to leiomyosarcoma have not been fully identified. Therapeutic strategies include liver wedge resection or lobectomy, chemotherapy, radiotherapy and liver transplantation; however, the prognosis of primary hepatic leiomyosarcoma is dismal.

CASE SUMMARY

We describe here the first case of primary hepatic leiomyosarcoma successfully treated by transcatheter arterial chemoembolization (TACE). The patient was a 68-year-old woman who presented with right upper quadrant pain and weight loss over the past 5 wk before admission. Abdominal computed tomography (commonly known as CT) and ultrasonography showed a mixed echoic mass measuring about 10 cm × 7 cm occupying the right lobe of the liver. Exploratory laparotomy was performed 1 wk after admission. The tumor was unresectable and biopsy was performed. Based on rapid frozen-section and histopathological examination, a final diagnosis of primary hepatic leiomyosarcoma was established. TACE was performed 2 wk later. The postoperative course was uneventful and the patient was discharged on day 7 after the operation. Contrast-enhanced CT showed that the tumor significantly shrunk with satisfactory lipiodol deposition. The patient has been followed up for 82 mo until now, and no progressive enlargement of the tumor or distal metastasis was observed.

CONCLUSION

TACE is a safe and effective treatment for primary hepatic leiomyosarcoma. The therapeutic effect of TACE combined with surgical resection should be further assessed.

Keywords: Treatment; Prognosis; Transcatheter arterial chemoembolization; Primary hepatic leiomyosarcoma; Case report

Core tip: Primary hepatic leiomyosarcoma is rare and reported sporadically. We here describe the first case of primary hepatic leiomyosarcoma successfully treated with transcatheter arterial chemoembolization (commonly known as TACE). The postoperative course was uneventful and the patient was discharged on day 7 after the operation. Contrast-enhanced computed tomography showed that the tumor significantly shrunk with satisfactory lipiodol deposition. The patient has been followed up for 82 mo until now, and no progressive enlargement of the tumor or distal metastasis was observed. This case indicates that TACE is a safe and effective treatment for primary hepatic leiomyosarcoma.