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Primary malignant mesothelioma of the liver: MR imaging findings
Polytimi Leonardou1, Richard C Semelka, Masayuki Kanematsu
1Department of Radiology and Pathology, University of North Carolina, Chapel Hill, NC 27599-7510, USA.
Abstract:
We report the MR imaging findings of a primary malignant mesothelioma of the liver arising from Glisson's capsule. A 54-year-old woman, presenting with acute abdominal pain and a large liver mass previously shown on CT, underwent MR imaging to characterize the lesion. The tumor was a greater than 12 cm tumor located in the right lobe of the liver, which was sharply marginated, with heterogeneous internal signal, septations and central necrosis. The tumor was considered a hepatocellular carcinoma. The diagnosis of malignant mesothelioma was established by immunohistochemical staining and electron microscopy of the resected tumor.
Insights
This study details MR imaging of a rare primary malignant mesothelioma of the liver. The findings highlight key imaging characteristics that can aid in diagnosing this unusual liver tumor.
Area of Science:
- Radiology
- Oncology
- Pathology
Background:
- Primary malignant mesothelioma of the liver is an extremely rare hepatic neoplasm.
- Glisson's capsule is the typical origin for these tumors.
Observation:
- A 54-year-old woman presented with acute abdominal pain and a large right lobe liver mass.
- Initial CT suggested hepatocellular carcinoma.
- MR imaging revealed a >12 cm, sharply marginated mass with heterogeneous internal signal, septations, and central necrosis.
Findings:
- MR imaging characteristics of the liver mass were analyzed.
- Immunohistochemical staining and electron microscopy confirmed the diagnosis of malignant mesothelioma.
- The tumor was initially misdiagnosed as hepatocellular carcinoma based on imaging.
Implications:
- Accurate MR imaging characterization is crucial for diagnosing rare liver tumors.
- This case underscores the importance of integrating imaging findings with histopathology for definitive diagnosis.
- Understanding the imaging features of primary liver mesothelioma can improve diagnostic accuracy and patient management.
