Characterization of primary hepatic carcinosarcoma by contrast-enhanced ultrasonography: A case report

Figure 1 Conventional ultrasonography of a primary hepatic carcinosarcoma. A: Gray-scale ultrasonography showed an ovoid heterogeneous echogenic mass in the right liver; B: Color doppler imaging showed the right hepatic vein compressed by the mass (arrow).

Figure 2 Contrast-enhanced ultrasonography of a primary hepatic carcinosarcoma. A: Contrast-enhanced sonography showed early intense peripheral nodular enhancement in the arterial phase (21 s) with two feeding arteries (arrows); B: Peripheral nodular portion of the tumor was iso-enhancing compared to the surrounding liver in the portal phase (76 s); C: Peripheral nodular portion of the tumor was washed out and was hypo-enhanced compared to the liver in the later phase (191 s).

Figure 3 Contrast-enhanced computed tomographic of a primary hepatic carcinosarcoma. A: Contrast-enhanced computed tomographic revealed peripheral nodular enhancement in the arterial phase with a large internal non-enhancing portion, which correlated with contrast-enhanced ultrasonography findings; B: Peripheral nodular portion of the tumor was isoenhanced in the portal phase.

Figure 4 Pathologic findings of the primary hepatic carcinosarcoma (hematoxylin and eosin, original magnification × 200). A: A section of the gross specimen showing a well-demarcated, peripheral nodular solid mass with a central area of necrosis and hemorrhage; B: Light microscopy showing moderate hepatocellular carcinoma; C: Stromal sarcoma components are comprised of spindle cells; D: Atypical spindle and epithelial cells are seen, which are consistent with hepatic carcinosarcoma.