Undifferentiated embryonal sarcoma of the liver presenting as a hemorrhagic cystic tumor in an adult

Background Undifferentiated embryonal sarcoma (UES) of the liver is a rare, highly malignant neoplasm with a poor prognosis occurring almost exclusively in late childhood (6–10 years of age). Only a few cases have been reported in adults, accounting for less than 1% of all primary liver neoplasms. Methods A 47-year-old woman presented with a palpable mass in the left upper abdomen. Magnetic resonance imaging revealed a 12×10 cm cystic mass with hemorrhage in the left lateral segment of the liver. The initial impression was a hemorrhagic cystic tumor of the liver. The patient underwent a left lateral sectionectomy of the liver. Histopathology and immunohistochemistry helped make a diagnosis of UES. Results The patient recovered uneventfully and received systemic chemotherapy. Radiologie examination for follow-up revealed a metastatic lesion in the lumbar spine (L5). She was subjected to radiotherapy at the lumbar spine. She survived 48 months. Conclusions Although hepatic cyst as UES of the liver is diffcult to diagnose because of its rarity in adults and lack of specifc findings, it should be considered in a differential diagnosis.