石原 昭彦¹, 北川 直之¹, 辻 泰弘¹, 春藤 譲治¹, 伊東 進¹, 岸 清一郎¹, 森 博愛¹, 島村 善行³, 長谷川 博⁴

Akihiko ISHIHARA¹, Naoyuki KITAGAWA¹, Yasuhiro TSUJI¹, Joji SYUNDO¹, Susumu ITO¹, Seiichiro KISHI¹, Hiroyoshi MORI¹, Yoshiyuki SHIMAMURA³, Hiroshi HASEGAWA⁴

¹徳島大学医学部第二内科, ²徳島大学医学部第一病理, ³国立療養所松戸病院外科, ⁴国立がんセンター病院外科

¹The Second Department of Internal Medicine, University of Tokushima, School of Medicine, ²The First Department of Pathology, University of Tokushima, School of Medicine, ³Department of Surgery, National Matsudo Hospital, ⁴Department of Surgery, National Cancer Center Hospital

キーワード : Leiomyosarcoma, Ultrasonography, Liver hypoechoic lesion, Mosaic pattern

A case of leiomyosarcoma of the liver in a 65-year-old man was reported.
Laboratory examinations showed mild liver dysfunction (TTT5.6, ICG R₁₅ 15%), but tumor markers including AFP were within normal limits except for slightly elevated CEA (6.8 ng/ml).
Ultrasonography (US) demonstrated a smooth and round hypoechoic lesion with irregular echogenic spots in medial segment of left hepatic lobe, which was about 3.9×3.0 cm in diameter.
CT scan showed a round low density area and scintigraphy showed a cold nodule. Angiography disclosed slightly irregular tumor vessels, but not tumor stain nor hypervasculanty.
Hepatoma of left hepatic lobe was suspected preoperatively. The resected tumor was measured 4.0×3.7×3.5 cm in diameter and contained necrotic areas. Histologically it was a typical leiomyosarcoma with many mitotic figures.