Background : Primary malignant liver mesenchymal tumor is a very rare tumor, accounting for less than 1% of all hepatic malignancies[1]. Hepatic angiosarcoma, leiomyosarcoma, embryonal sarcoma, schwannoma and lymphoma are common mesenchymal tumors. The diagnosis is dependent on histological imaging. We present a case of malignant liver mesenchymal tumor in an adult and its diagnosis and treatment were discussion.

Methods : A 21-year-old Mongolian female was admitted to our hospital with a 2 week history of mild abdominal pain, an abdominal mass in the right upper quadrant, fatigue and progressive weight loss. Her symptoms gradually worsened with fatigue 8 mo after onset of the disease. She had no fever, cough, no family history of liver and autoimmune diseases. Physical examination revealed enlargement of the liver and percussion abdominal pain. Her complete blood count: hemoglobin was 71 g/L, Platelet 1012*1012/L) . Liver functional test showed that his alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, total bilirubin, and albumin were 9,3 U/L, 11,2 U/L, 205 U/L, 7,9 μmol/L, 25.5 g/L, respectively. Series hepatitis markers ( hepatitis B virus, hepatitis C virus) were negative. α-fetoprotein, carcinoembryonic antigen and CA19-9 were concentrations were also normal. Human immunodeficiency virus(HIV) and syphilis antibodies were negative. Tuberculosis test negative. Abdominal CT demonstrated large enhancing mass in contrast phase and abnormal signals suggestive of a possible malignant tumor.

Results : Multidisciplinary team decided a surgical treatment. The patient underwent an uneventful operation hepatic resection SVI and histology demonstrated a malignant mesenchymal tumor with clear resection margins. In this paper, we presented a case of Large enhance lesions in liver. The final diagnosis was a malignant mesenchymal tumor. However, H&E staining could not show the source of mesenchymal cells. Immunohistochemistry staining such as Vimentin, Desmin and α-SMA was positive. used to diagnose the tumor that is malignant mesenchymal tumor.

Conclusions : Mesenchymal liver tumors, which are either benign or malignant in nature. The cross-sectional imaging findings regarding other mesenchymal liver tumors are variable, and overlapping may occur among them, particularly in the case of the more common malignant tumors. therefore mesenchymal tumors are difficult to diagnosis by clinically and can be differentiated by pathologically.