Primary Liver Leiomyosarcoma - Mimicking Liver abscess

Primary hepatic leiomyosarcoma is very rare with only sporadic cases reported. The usual clinical presentation is hepatomegaly or epigastric mass, which is commonly associated with abdominal pain or body weight loss. We reported a 60-year-old man who presented with intermittent low grade fever and right upper quadrant pain. Dynamic CT scan of liver revealed a big mass in right lobe of liver, which showed wall and internal septa enhancement in arterial and portal venous phase images. Although the clinical presentation and CT features suggested a hepatic abscess, a percutaneous aspiration procedure was performed and in favor of tumor growth thereafter. Right lobectomy was then performed. The final pathological report was high grade primary hepatic leiomyosarcoma.