Massive undifferentiated embryonal sarcoma: An unusual primary hepatic malignancy

Undifferentiated embryonal sarcomas of the liver (UESLs) are mesenchymal tumors that commonly occur in children aged 5-20 years. It is a rare, aggressive tumor with nonspecific symptoms and imaging appearance. Radiologically, it usually presents as a large heterogeneous mass with solid and cystic components arising from the liver. However, correlation with histopathology is required to achieve a definitive diagnosis. The mainstay of treatment is surgery and chemotherapy with improved survival outcomes. We present a case of a 6-year-old boy with a large heterogenous embryonal sarcoma arising from the right liver lobe, diagnosed on histology after radical resection. As the patient presented initially with various non-specific flu-like symptoms, this case highlights the crucial role of a multidisciplinary approach, including radiology, pathology, and surgical oncology, in diagnosing and treating this rare and aggressive hepatic tumor, which is essential for early surgical resection to enhance patient survival rates.