Primary malignant mesenchymal tumour of the liver in an elderly female

A case of primary malignant mesenchymal tumour of the liver occurring in an 86-year-old woman is described. This very uncommon tumour has previously only been described in children and young adults, the previous oldest being 28 years of age. The tumour was large, rapidly growing though well circumscribed and extensively necrotic. Microscopically it was mostly composed of spindle cell sarcoma without differentiating features. Epithelial lined ductules were seen throughout the tumour and degenerate hepatocytes were enveloped in the tumour peripherally. Intracytoplasmic and extracellular PAS-positive, diastase-resistant bodies were present, some showing positive staining for alpha-I-antitrypsin. The tumour is compared with previous reports and its differential diagnosis and nomenclature discussed.