Primary malignant fibrous histiocytoma of the liver

A 73-year-old male patient with an incidental finding of a solitary mass of the right lobe of the liver was referred to our hospital. Tumor serum markers were within normal limits. The CT scan showed a 7-cm well circumscribed hypodense mass of liver segment VII enhanced minimally during the portal venous phase with marked enhancement on the delayed images (Panels A,B). Upper and lower GI endoscopy revealed negative findings. A liver resection of segments VII and VIII was performed. Histopathology revealed a circumscribed liver tumor measured 6.5 cm × 8.5 cm × 5 cm with a white—yellowish sectional surface and firm consistency with a predominant spindle—shaped morphology and a mitotic activity of 1？3 mitoses/10 HPF. Immunohistaining presented a positive reaction of neoplastic cells to vimentin, alph-1-antichemothrypsin and CD68 and a negative reaction to desmine and actine (Panels C,D, ×250). The diagnosis of primary malignant fibrous histiocytoma was made according to morphology and the immunohistochemistry criteria