Malignant fibrous histiocytoma presenting as hemoperitoneum mimicking hepatocellular carcinoma rupture.
Malignant fibrous histiocytoma (MFH) is a pleomorphic mesenchynal sarcoma. It is uncommonly arises primarily from the intra-peritoneal cavity. Primary peritoneal MFH with tumor bleeding and rupture is rare. We describe the imaging features of a 70-year-old patient presenting with ruptured hemorrhagic peritoneal MFH at subhepatic area, accompanied by massive hemoperitoneum, mimicking a ruptured pedunculated hepatocellular carcinoma. Computed tomography (CT) revealed a large heterogeneous enhanced subhepatic mass with adjacent liver, gallbladder and colon invasion. Tumor hemorrhage and rupture complicated with peritoneal seeding and massive bloody ascites were also detected. Angiography showed a hypervascular tumor fed by enlarged right hepatic arteries, cystic artery and omental branches of gastroepiploic artery. The patient underwent laparotomy for tumor resection, but the tumor recurred one month after operation. To our knowledge, the CT appearance of ruptured intraperitoneal MFH complicated by hemoperitoneum has not been previously described.
Chen
Hsin-Chi
HC
Department of Radiology, Cathay General Hospital, Hospital Sijhih Branch, No. 2, Lane 59, Jiancheng Road, Sijhih City, Taipei, Taiwan, China. hsinchi.chen715@msa.hinet.net
Chen
Chi-Jen
CJ
Jeng
Chin-Ming
CM
Yang
Chan-Ming
CM
D000368:Aged; D001201:Ascites / Q000209:etiology; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis*; D003937:Diagnosis, Differential; D004621:Embolization, Therapeutic; D017809:Fatal Outcome; D006465:Hemoperitoneum / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D006470:Hemorrhage / Q000150:complications* / Q000209:etiology / Q000473:pathology; D051677:Histiocytoma, Malignant Fibrous / Q000098:blood supply / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D006801:Humans; D008099:Liver / Q000473:pathology*; D008113:Liver Neoplasms / Q000175:diagnosis*; D008297:Male; D009361:Neoplasm Invasiveness; D009362:Neoplasm Metastasis; D010534:Peritoneal Neoplasms / Q000098:blood supply / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D012422:Rupture, Spontaneous; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome