Resumen

RENDO, Andry et al. Leiomiosarcoma hepático: Reporte de un caso y revisión de la literatura. Gen [online]. 2008, vol.62, n.3, pp.230-232. ISSN 0016-3503.

Primary sarcomas of hepatic location fundamentally constitute a group of exceptional tumors in the adult, amounting its incidence according to the series consulted between a 0,1-1%, of all the malignant hepatic tumors of the adult the average age of presentation could be located between the fourth and fifth decade, with referred extreme ages in the bibliography of 22 and 77 years. The most frequent symptom of hepatic sarcomas, independently of the histological type, is pain of small to medium intensity in superior hemiabdomen, that itÊs usually accompanied by other unspecific symptoms, like ponderal loss, vespertine febrícula and asthenia. Clinical Case: Male patient 20 years old, begins symptoms in february of 2005, presenting general weakness and progressive loss of weight quantified at 8 kg From the beginning of March of 2005 demonstrates cutaneous paleness, hyperthermia preceded of chills, of vespertine predominance, , opressive, not radiated, pain in the epigastric region, reason why he consults a facultative in his locality, where he is hospitalized with the diagnosis of hepatic abscess. He remains 30 days, receiving antibiotic treatment without improvement, needing a transfusion because of Hb levels of 6 gr.dl, without evident signs of bleeding. Abdominal Ultrasound: Hepatoesplenomegalia and SOL in left hepátic lobe Normal gastroscopy and colonoscopy. Abdominal magnetic resonance: Evidence of hepatomegalia associated to the presence of lesion of tumorlike appearance in the left hepatic lobe, with heterogenous enhancement. The evolution was not the one of an hepatic abscess and the ultrasound image is of solid behavior, reason why laparoscopic diagnostic surgery is suggested. The possibility of a guided ultrasound percutaneous sample is ruled out because of the high probability of bleeding .A left hepatectomy is done Biopsy: reports hepatic leiomiosarcoma. After surgery the patient evolves satisfactorily. Conclusion: In spite of its uncommoness, hepatic sarcomas must be taken into account in the differential diagnosis from solid hepatic tumors in the adult, in absence of cirrhosis. The only treatment that allows survival expectations is the surgical one, by means of regulated or atypical hepatectomy with safety margins and in some cases even hepatic transplants.

Palabras clave : Hepatic tumor; sarcoma; leiomiosarcoma.