title: Undifferentiated embryonal sarcoma with unusual features arising within mesenchymal hamartoma of the liver: report of a case and review of the literature.
abstract: Undifferentiated embryonal sarcoma (UES) is a rare and highly malignant hepatic neoplasm, affecting almost exclusively the pediatric population. It has replaced malignant mesenchymoma, under which diagnostic term the first three cases were described. A link between embryonal sarcoma and mesenchymal hamartoma of the liver (MHL) has long been proposed, because of clinicopathologic overlaps of these entities; however, until recently, this association remained tenuous. Cases of UES arising in a background of mesenchymal hamartoma of the liver have previously been reported in two teenage girls. Discovery of a similar genetic abnormality in MHL and UES has clinched the supposed link between them. There have also been two reports of UES with prominent cystification, one associated with peripheral eosinophilia, and thereby masquerading as hydatid cyst of the liver. We report a case of UES arising in a young boy with MHL, with unusual histologic features, including large mesothelial-lined cysts and ectopic adrenal cortical tissue under Glisson's capsule.
authors.affiliation: L. V. Ackerman Laboratory of Surgical Pathology, Washington University Medical Center, St. Louis, MO 63110, USA.
authors.forename: M J
authors.initials: MJ
authors.lastname: O'Sullivan
authors.forename: P E
authors.initials: PE
authors.lastname: Swanson
authors.forename: J
authors.initials: J
authors.lastname: Knoll
authors.forename: E M
authors.initials: EM
authors.lastname: Taboada
authors.forename: L P
authors.initials: LP
authors.lastname: Dehner
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000032:analysis; D002467:Cell Nucleus / Q000648:ultrastructure; D002675:Child, Preschool; D002871:Chromosome Banding; D002880:Chromosomes, Human, Pair 11; D002888:Chromosomes, Human, Pair 19; D002945:Cisplatin / Q000008:administration & dosage; D003520:Cyclophosphamide / Q000008:administration & dosage; D022083:Cytoplasmic Structures / Q000648:ultrastructure; D003609:Dactinomycin / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D004848:Epithelium / Q000473:pathology; D006222:Hamartoma / Q000737:chemistry / Q000235:genetics / Q000473:pathology* / Q000628:therapy; D006801:Humans; D007124:Immunoenzyme Techniques; D008113:Liver Neoplasms / Q000737:chemistry / Q000235:genetics / Q000473:pathology* / Q000628:therapy; D008297:Male; D008648:Mesoderm / Q000737:chemistry / Q000473:pathology*; D009373:Neoplasms, Germ Cell and Embryonal / Q000737:chemistry / Q000235:genetics / Q000473:pathology* / Q000628:therapy; D012509:Sarcoma / Q000737:chemistry / Q000235:genetics / Q000473:pathology* / Q000628:therapy; D014178:Translocation, Genetic; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D014408:Biomarkers, Tumor; D003609:Dactinomycin; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D002945:Cisplatin