Unusual presentation of an embryonal sarcoma of the liver in an adult.

Embryonal sarcoma of the liver (ESL) is an aggressive tumor of childhood and rare in adults. Herein, we report an ESL in a 37-year-old female patient, who presented with liver rupture and acute abdomen. ESL was not considered in preoperative clinical differential diagnoses due to its rarity and the diagnosis was not established in the preoperative liver aspirate. This study highlights the fact that ESL should be considered as an uncommon malignant tumor in adults affecting commonly the right lobe of the liver, especially when the serum alpha-fetoprotein level is within normal ranges. Histological examination is essential to establish the diagnosis with ancillary tests. Due to its rarity, although a definitive mode of therapy is not known, postoperative adjuvant chemotherapy is effective in achieving symptom-free recovery. The index patient developed omental metastasis after 9 months of diagnosis and such a presentation is possibly an indicator of aggressive tumor behavior.