The Role of Contrast Enhanced Ultrasound (CEUS) in assessing a rare Undifferentiated Embryonal Sarcoma of the Liver: A case study

Abstract

Focal liver lesions are common findings in Diagnostic Imaging, but not all liver lesions are common.  Complex, unique hepatic tumours can be challenging to differentiate and diagnose regardless of imaging modality.  An example of this is demonstrated in a case of a 23 year old female with a large liver mass comprised of cystic, solid, and hemorrhagic components.  The lesion lacked classic features on imaging, so a Contrast Enhanced Ultrasound (CEUS) was performed to further interrogate the solid aspects of the mass.  The study provided reliable findings indicative of a primary hepatic malignancy, supporting previously performed radiology examinations, laboratory results, and ultimately the patient’s diagnosis of an undifferentiated embryonal sarcoma of the liver.  Results from the CEUS exam assisted to accelerate proper management for the patient without the need for an invasive tissue biopsy, additional radiation exposure, or increased risk of nephropathy.  This case study further outlines the benefits and value of CEUS in the evaluation of the patient’s hepatic lesion, and its use in the continued assessment of focal liver lesions.