Primary leiomyosarcoma of the liver--a case report.

This is the 17th report on primary leiomyosarcoma of the liver in world literature. In 1980, a 69-year old white female patient was admitted with pain in the right upper abdomen and loss of weight of 12 kg. Increased blood sedimentation rate, elevated serum markers of the liver and ultrasound evolved a big tumor of the right liver without extrahepatic tumor nodules. Right hemihepatectomy was undertaken, the tumor was completely resected. After histologic examinations, leiomyosarcoma of the liver with 1 mitosis per 10 high power fields was diagnosed. 10 years later, the patient was readmitted with symptoms of pain, tiredness and night sweat. At this time, 3 intrahepatic and 1 retroperitoneal tumor nodules were detected. A sure-cut needle biopsy revealed the recurrent leiomyosarcoma with 4 mitoses per 10 high power fields. The survival period of 10+ years is the longest of all 17 patients with primary hepatic leiomyosarcoma reported so far. The low rate of mitoses per high power field and primary surgical resection are considered the reasons for the long survival period.