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Kim and Kim: Primary Undifferentiated High-Grade Pleomorphic Sarcoma in the Perihepatic Space: A Report of a Case
Abdominal Radiology

Journal of the Korean Society of Radiology 2015; 73(1): 49-52.

Published online: 24 June 2015

DOI: https://doi.org/10.3348/jksr.2015.73.1.49

Primary Undifferentiated High-Grade Pleomorphic Sarcoma in the Perihepatic Space: A Report of a Case

Ki Beom Kim, MD, Seong Hoon Kim, MD

Department of Radiology, Daegu Fatima Hospital, Daegu, Korea.

Corresponding author: Seong Hoon Kim, MD. Department of Radiology, Daegu Fatima Hospital, 99 Ayang-ro, Dong-gu, Daegu 701-724, Korea. Tel. 82-53-940-7165, Fax. 82-53-954-7417, nosmokeman@naver.com

Received 5 January 2015       Accepted 14 May 2015

Copyright © 2015 The Korean Society of Radiology

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Undifferentiated high-grade pleomorphic sarcoma (UPS) is a pleomorphic soft tissue sarcoma derived from histiocytes capable of fibroblastic transformation. UPS affects soft tissues of the body, especially the extremities and retroperitoneum, and primary UPS in the perihepatic space is extremely rare. We report a case of primary perihepatic UPS in a 44-year-old male, who presented with fever and right upper abdominal discomfort.

Keywords: Undifferentiated Pleomorphic Sarcoma, Malignant Fibrous Histiocytoma, Peritoneal, Perihepatic, Ultrasound, Computed Tomography, Magnetic Resonance Imaging

Figures and Tables

Fig. 1

A 44-year-old man presented with primary perihepatic undifferentiated high-grade pleomorphic sarcoma.

A. Transverse ultrasonography image shows a huge mass composed of a cystic component with multiple septations and a heterogeneous echogenic solid portion in the periphery.
B. Contrast enhanced CT shows a 14.5 × 7.5 cm-sized cystic and solid mass with multiple thick septae in the right perihepatic space.
C. T2-weighted MR image shows a well-circumscribed huge mass which was heterogeneously hyperintense with multiple thick septae and cavities of variable sizes.
D. T1-weighted MR image shows an isointense signal in the peripheral solid portion with inner foci of high signal intensity, representing hemorrhage.
E. Hepatobiliary phase of gadoxetic acid-enhanced MR image shows a low signal intensity of the peripheral solid portion in the mass compared with a high signal intensity of the normal liver parenchyma.
F. Positron emission tomography-CT shows intense fluorodeoxyglucose uptake in the peripheral solid portion of the mass, but not in the cystic portion.
G. Gross pathological cut section shows a well-defined huge mass measuring about 21 × 17 × 10 cm. Mass shows massive hemorrhagic necrosis (arrows).
H. A microphotograph shows multinucleated giant cells showing pleomorphism, small round cells, and histiocyte-like cells (hematoxylin and eosin staining, × 200).
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