Primary Leiomyosarcoma of the Liver: Case Report and Literature Reviews

Primary liver sarcomas are rare, accounting for only 1–2% of primary liver malignancies, with leiomyosarcoma comprising 13.9% of liver sarcomas. Radiologically, liver leiomyosarcomas exhibit significant variability, typically presenting as large, heterogeneous masses with irregular margins, necrotic regions, and complex enhancement patterns. Imaging may reveal intratumoral hemorrhage, diffusion restriction, and distinctive whirling or bundled structures. The differential diagnosis is broad and includes hepatocellular carcinoma, angiosarcoma, and neuroendocrine carcinoma.