2018 Volume 59 Issue 1 Pages 56-64
An octogenarian female was admitted to our hospital with anorexia. Hematologic tests revealed the elevation of inflammatory response besides high ALP value. Computed tomography demonstrated ischemic liver mass with marginal contrast enhancement as 80 mm diameter. The tumor biopsy was performed and it resulted in no malignancy but also some kind of abscess. Although antibiotics was administered for a month, inflammatory reactions persisted and the size of the tumor increased gradually, therefore the biopsy was enforced again. The results indeed demonstrated the suspicion of sarcoma, so posterior segmentectomy of right hepatic lobe was operated. Histopathological analysis indicated sheet-like growing tumor cells with nuclear atypia, which were positive for vimentin and AE1/AE3. Final diagnosis was undifferentiated carcinoma of the liver (so called sarcomatoid carcinoma). Primary undifferentiated carcinoma of the liver is rare and often difficult to distinguish from liver abscess because of the inflammatory response and the similarity in imaging examination.