TITLE:
Positron Emission Tomography/Computed Tomography and Magnetic Resonance Imaging Findings of Primary Leiomyosarcoma of the Liver: A Case Report and Literature Review
AUTHORS:
Jingyi Jiang, Jianyu Cui, Yongjun Peng
KEYWORDS:
Primary Hepatic Leiomyosarcoma, FDG PET/CT, MRI
JOURNAL NAME:
Journal of Biosciences and Medicines,
Vol.13 No.10,
October
24,
2025
ABSTRACT: Background: Primary hepatic leiomyosarcoma (PHL) is an exceedingly rare malignant neoplasm, accounting for only 0.2% - 2% of all primary hepatic malignancies. Its non-specific clinical and imaging features often lead to misdiagnosis. Aim: This study aims to delineate the MRI and FDG PET/CT imaging findings in a patient with multiple primary hepatic leiomyosarcomas and to review the relevant English-language literature from 2000 to 2024, focusing on the MR and PET/CT characteristics of PHL. Case Presentation: We report the case of a 62-year-old male with no significant medical history who was incidentally found to have multiple intrahepatic lesions. Contrast-enhanced MRI revealed well-defined nodules showing T1 hypointensity, T2 hyperintensity, restricted diffusion, and progressive peripheral enhancement. FDG PET/CT demonstrated heterogeneous radiotracer uptake with SUVmax values ranging from 5.1 to 12.0. Histopathological examination of resected specimens confirmed the diagnosis of PHL. Conclusion: PHL, though typically presenting as a solitary mass, can manifest as multiple intrahepatic lesions. MRI is essential for lesion characterization, while PET/CT is valuable for staging and detecting extrahepatic disease. Awareness of its imaging spectrum is crucial for accurate diagnosis. Future integration of imaging omics and machine learning may further enhance diagnostic precision.