Atypical lipomatous tumor in the ligamentum teres of liver: A case report and review of the literature

Figure 1 Abdominal ultrasonography shows mosaic echoic tumor at ventromedian. Tumor has poor blood flow signal and a linear hyperechoic part inside and a clear border to the surroundings.

Figure 2 Dynamic CT and MRI of the abdomen show a ventromedian tumor in front of pancreas. CT reveals high enhanced effect of tumor from portal-venous phase continuing to the equilibrium phase (red arrow). T1-weighted gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced image revealed a high intensity effect at the early phase, which continued to the next phase (red arrow). In addition, it showed a partial low intensity area by a fat suppression image (yellow arrow). On the other hand, the T2-weighted image did not show a high intensity effect. Gd: Gadolinium; EOB: Ethoxybenzyl; DTPA: Diethylenetriamine pentaacetic acid-enhanced; FS: Fat suppression.

Figure 3 Intraoperative finding and macroscopic view of the resected split specimen. A: A tumor arising from the ligamentum teres of liver; B: A tumor measuring a maximum of 13 cm × 9 cm × 5 cm consisting of yellow lipid and a white fibrous component.

Figure 4 Microscopic view of the resected specimen. A: Lipid and fibrous component are confirmed. Lipid component consist of mature adipocytes. Hematoxylin and eosin staining (× 40); B: Deep dyeing multiforme or multinuclear atypical stromal cells are confirmed in fibrous component (red arrow). Hematoxylin and eosin staining (× 200); C: Immunostaining showed that atypical stromal cells were positive for MDM2 (× 400); D: Immunostaining showed that atypical stromal cells were positive for CDK4 (× 400).