Leiomiossarcoma Hepático Primário – Uma Neoplasia Rara com Desafios Diagnósticos e Terapêuticos
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Resumo
O leiomiossarcoma hepático primário (LHP) é uma neoplasia maligna rara, representando menos de 0,1% de todos os tumores primários do fígado. Originado das células musculares lisas dos vasos intra-hepáticos ou do ligamento redondo, seu diagnóstico é complexo e requer a exclusão de metástases e de outros sarcomas. Este relato de caso e revisão da literatura resume o conhecimento atual sobre a epidemiologia, apresentação clínica, abordagem diagnóstica e manejo terapêutico do LHP com base nos dados publicados. A apresentação clínica é inespecífica, geralmente com dor abdominal e massa palpável. A ressecção cirúrgica radical (R0) é o único tratamento potencialmente curativo, mas a alta taxa de recidiva local e metastática impacta negativamente o prognóstico. Quimioterapia e radioterapia têm papel limitado, seja de forma paliativa ou adjuvante. A sobrevida global em 5 anos é baixa (15–30%), o que reforça a necessidade de diagnóstico precoce e de estratégias terapêuticas multimodais mais eficazes.
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