THE COMPLEX IMAGING DIAGNOSIS OF UNDIFFERENTIATED EMBRYONAL SARCOMA OF THE LIVER IN CHILDREN: THE OWN EXPERIENCE AND LITERATURE REVIEW
Background. Undifferentiated embryonal sarcoma of the liver (UESL) is a rare malignant mesenchymal tumor that occurs predominantly in children. Diagnosis delay often happens due to the deficiency of clinical symptoms, radiological findings, and serological markers. Objektive was to describe the imaging features of the undifferentiated embryonal sarcoma of the liver in children. Materials. Six children with UESL (5 girls and 1 boy) were observed and treated at the Research Center of Pediatric Oncology between 2008 and 2016. The median age was 6.5 years (from 4 months to 11 years). The diagnosis was confirmed by histological and immunohistochemical analysis. Abdominal ultrasonography (US), abdominal computed tomography (CT), and magnetic resonance imaging (MRI) were performed. Results. The enormous solitary well circumscribed mass with irregular contours without invasion of liver vessels were revealed by US, CT, and MRI. In 5 cases, the tumors didn’t disturbed the fibrocapsule. Five tumors showed solid appearance with some little anechoic areas in abdominal US, while at CT and MRI UESL had predominantly cyst-like structure due to the high water content of the prominent myxoid stroma. After intravenous contrast administration predominantly peripheral enchancement and solid parts of the mass was determined at CT and MRI in all cases. Conclusion. Imaging data reveal discrepancy between US and CT/MRI appearance of UESL that can help to suspect this tumor. It is necessary to perform the morphological investigation when UESL is suspected.