Hepatic sclerosing epithelioid fibrosarcoma in an adolescent patient. Case report and literature review

Background: Sclerosing epithelioid fibrosarcoma (SEF) is a rare subtype of fibrosarcoma, with only a handful of pediatric cases reported in the literature. Previous publications have primarily focused on the pathological aspects, with no documented descriptions of the imaging characteristics of hepatic Sclerosing epithelioid fibrosarcoma. Case Presentation: A 17-year-old female with chronic abdominal pain was found to have a large, solid, hypoechoic mass in the right hepatic lobe with prominent posterior acoustic shadowing on ultrasonography (US). Contrast-enhanced magnetic resonance imaging (MRI) further characterized the lesion as a T1/T2 hypointense mass with delayed progressive enhancement and a T2-blackout pattern on Diffusion Weighted Images (DWI) and Apparent Diffusion Coefficient (ADC) mapping. A core biopsy confirmed the diagnosis of sclerosing epithelioid fibrosarcoma, and the patient subsequently underwent liver transplantation. Conclusion: This report presents the first multimodality imaging characterization of primary hepatic sclerosing epithelioid fibrosarcoma in an adolescent, highlighting its unique radiologic features.