This patient was initially evaluated for a possible infectious disease, due to the initial biopsy findings. However, no proof of an infective agent was found after multiple laboratory tests. Alpha-fetoprotein (AFP) levels were in normal range.

A repeat US-guided biopsy revealed anaplastic fusiform cells with hyperchromatic multiple nuclei and a myxoid matrix associated with extensive necrosis, highly consistent with embryonal sarcoma of the liver.

This pathology is considered by some authors as the malignant counterpart of hepatic mesenchymal hamartoma.