Objective: To assess the diagnostic value of CT to primary hepatic sarcoma.
Methods: The CT findings of 12 cases of primary hepatic sarcomas confirmed by operation and pathology, including leimyosarcoma, liposarcoma, and malignant fibrous histocytoma, 2 cases each, and angiosarcoma, carcinosarcoma, cystadenocarcinosarcoma, mesotheliosarcoma, fibrosarcoma, and malignant lymphoma, one case each, were analysed retrospectively.
Results: Only 2 out of the 12 cases of primary hepatic sarcoma were correctly diagnosed by CT before operation. The CT manifestations of primary hepatic sarcoma, against the operational and pathological findings, could be summarized as two types: solid mass type and cystic mass type. Eight cases were of solid mass type, including 2 cases of liposarcoma, and leiomyosarcoma, angiosarcoma, carcinosarcoma, methotheliosarcoma, fibrosarcoma, and malignant lymphoma, one case each. Plain scanning showed homogeneous or inhomogeneous low-density masses; enhanced scanning showed no marked enhancement or inhomogeneous enhancement, ringed peripheral enhancement, or nodular peripheral enhancement. Peripheral enhancement was a CT feature common to angiosarcoma and lymphoma. The characteristic CT manifestation of liposarcoma was an inhomogeneous mass with well-defined border and multiple intermingled septa. Four cases were of cystic mass type, including 2 cases of malignant fibrous histocytoma, and leimyosarcoma with post-operative recurrence and cystadenocarcinosarcoma, one case each, all manifesting a huge single cystic mass: unilocular in the case of leimyosarcoma with post-operative recurrence and multilocular in the other 3 cases. The wall and/or septa of the cyst had an uneven thickness and were markedly enhanced after contrast administration. Clear solid element and wall nodules were seen in the cystic mass of cystadenocarcinosarcoma.
Conclusion: The CT findings of primary hepatic sarcoma are associated with the pathology of tumor. Some pathological patterns of primary hepatic sarcoma, such as liposarcoma and angiosarcoma, have their own characteristic CT manifestations. However, the diagnosis of most primary hepatic sarcoma lacking characteristic CT manifestations must be based on clinical and laboratory examinations and confirmed by pathology.