Primary Hepatic Leiomyosarcoma Presenting as a Multiloculated Cystic Mass: A Case Report and Review of Literature

Primary hepatic leiomyosarcoma (PHL) is a rare malignant mesenchymal tumor representing a small fraction of primary hepatic cancers. Due to its nonspecific clinical and radiologic presentation, it is often misdiagnosed. We present the case of an 82-year-old male who presented with altered mental status and was found to have a multiloculated cystic mass in the liver, initially suspected to be a hepatic abscess. Histopathological evaluation of the mass revealed a diagnosis of PHL. Despite palliative chemotherapy, the patient succumbed to metastatic disease within two months. PHL is a rare neoplasm with varied clinical manifestations. The unusual cystic presentation, as seen in this case, highlights the importance of maintaining a broad differential when evaluating hepatic masses.