PRIMARY LEIOMYOSARCOMA OF THE LIVER MIMICKING LIVER-ABSCESS

Primary hepatic leiomyosarcoma is a rare tumor, with fewer than 60 pre viously reported cases, The usual clinical presentation is painful hep atomegaly or a painful epigastric mass, We present the case of a 64-yr -old white man who presented with fevers, drenching night sweats, fati gue, leukocytosis, an elevated erythrocyte sedimentation rate, and an indistinct mass in the right lobe of his liver on CT scan, Although th e clinical presentation was suggestive of hepatic abscess, a percutane ous biopsy was consistent with a smooth muscle tumor, Successful right hepatic lobectomy resulted in resolution of all the associated sympto ms and signs, A review of the world literature produced 44 papers repo rting a total of 54 eases, The male:female ratio was 25:26; mean age w as 53.6 yr, The tumor tended to occur at an earlier age in women, with a group mean age of 49.0 yr compared with 58.4 for men, It was more c ommon in the right lobe, Metastatic disease was present in 40.9% of pa tients, The outcomes for various therapeutic approaches were compared, Patients treated with comfort measures alone had a mean survival or f ollow-up of 0.87 yr. The best outcome seemed to be in those patients t reated with a combination of surgery and chemotherapy, with a mean sur vival or follow-up of 3.3 yr.