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Int J Clin Exp Pathol 2012;5(8):824-829

Case Report
An undifferentiated embryonal sarcoma of the liver containing adipophilin-positive
vesicles in an adult with massive sinusoidal invasion

Satoshi Tanaka, Akira Takasawa, Yuichiro Fukasawa, Tadashi Hasegawa, Norimasa Sawada

Department of Pathology, Sapporo Medical University School of Medicine, Chuou-ku, Minami-1, Nishi-17, Sapporo 060-8556, Japan;
Department of Surgical Pathology, Sapporo City General Hospital, Chuou-ku, Kita-11, Nishi-13, Sapporo 060-8604, Japan; Department of
Surgical Pathology, Sapporo Medical University, School of Medicine, Chuou-ku, Minami-1, Nishi-16, Sapporo 060-8543, Japan

Received July 4, 2012; Accepted August 23, 2012; Epub October 1, 2012; Published October 15, 2012

Abstract: Undifferentiated embryonal sarcoma of the liver (UESL) is a malignant mesenchymal tumor that occurs typically in children and rarely
in adults. Here we describe a case of UESL in a 51-year-old woman who presented with a cystic lesion in the liver. Because it grew slowly, the
anterior segment of the liver was resected to check the lesion. Histologically, the lesion looked like a telangiectatic hepatic adenoma. Two
years after resection, the tumor recurred, and she died 3 years later due to liver failure. The autopsy revealed that these lesions were UESL with
massive sinusoidal invasion, and a review of the case indicated the primary lesion was also UESL. We also confirmed these tumor cells by
staining with CD56, alpha-smooth muscle actin (SMA), and adipophilin, suggesting that they have a character similar to that of stellate cells in
the space of Disse. The histological result of our patient revealed atypical UESL. Therefore, UESL should be considered when a hepatic lesion
with degeneration is seen, even in an adult. In addition, the immunohistochemical appearance of this case implies that UESL is perhaps
derived from stellate cells or stellate cells with myofibroblast differentiation in the space of Disse. (IJCEP1207003)

Keywords: Adipophilin, adult, hepatic adenoma, liver, stellate cell, undifferentiated embryonal sarcoma

Address all correspondence to:
Dr. Satoshi Tanaka, Department of Pathology, Sapporo Medical University School of Medicine, Chuou-ku, Minami-1, Nishi-17, Sapporo
060-8556, Japan. Tel: +81-11-611-2111 (ext. 2701); Fax: +81-11-613-5665; E-mail: binntana@sapmed.ac.jp