Comparison of the clinical and MRI features of patients with hepatic hemangioma, epithelioid hemangioendothelioma, or angiosarcoma

Abstract

<jats:title>Abstract</jats:title> <jats:p>Background Comparisons of hepatic epithelioid hemangioendothelioma (HEHE), hepatic hemangioma, and hepatic angiosarcoma (HAS) have rarely been reported. The purpose of our study was to analyze the clinical and magnetic resonance imaging (MRI) findings of these conditions.Methods A total of 57 patients (25 with hemangioma, 13 with HEHE, and 19 with HAS) provided hepatic vascular endothelial cell data between June 2006 and May 2017. The measurement data were represented as means±SDs. Between-group comparisons were performed using independent-samples t-tests. Count data were represented as frequencies or rates, and χ2- or Fisher’s exact tests were performed.Results The proportions of cases with circumscribed margins were 88% (22/25), 84.6% (11/3), and 31.6% (6/19) for hemangioma, HEHE, and HAS, respectively (P&lt;0.001). HAS lesions were less likely to have circumscribed margins. The proportions of lesions with hemorrhaging were 4% (1/25), 44.4% (4/13), and 36.8% (7/13) for hemangioma, HEHE, and HAS, respectively (P=0.014). HEHE and HAS cases were more likely to show heterogeneous signals on T1-weighted (T1WI) MRI. HEHE and HAS cases were more likely to show heterogeneous signals on T2-weighted (T2WI) MRI. Centripetal enhancement was the most common pattern in vascular tumors, with proportions of 100%, 46.2% (6/13), and 68.4% (13/19) for hemangioma, HEHE, and HAS, respectively. The difference in enhancement pattern between HEHE and HAS was not significant, but rim enhancement was more common for HEHE (46.2%, 6/13).Conclusions Our study revealed clinical and imaging differences between HEHE and HAS. The platelet count (PLT) and coagulation function of the HAS group decreased, whereas the alpha-fetoprotein (AFP) level increased. The 5-year survival rate for HAS was significantly lower than that of HEHE. A higher malignancy degree indicated a more blurred lesion margin, easier occurrence of hemorrhaging, and more heterogeneous plain T1WI and T2WI signals.</jats:p>

Angiosarcoma of the Pancreas in a Pediatric Patient With an Activating KDR-Internal Tandem Duplication: A Case Report and Review of the Literature

“…Outcomes and management of pediatric angiosarcoma of the liver have been reported 13. Hepatic angiosarcoma has been demonstrated to be associated with heterogenous peripheral enhancement on MRI in small studies 17. In addition, reports have described CT findings of pancreatic sarcomas can range wildly from heterogenous solid masses to highly enhancing heterogenous lesions with associated increased vascularization and necrosis 18,19…”

“…13 Hepatic angiosarcoma has been demonstrated to be associated with heterogenous peripheral enhancement on MRI in small studies. 17 In addition, reports have described CT findings of pancreatic sarcomas can range wildly from heterogenous solid masses to highly enhancing heterogenous lesions with associated increased vascularization and necrosis. 18,19 Our case is the eighth reported case of primary pancreatic angiosarcoma overall, and the first case to date of this pathology arising in an adolescent.…”

Đặc Điểm Lâm Sàng, Cận Lâm Sàng Và Hình Ảnh Chụp Cắt Lớp Vi Tính Của Bệnh Nhân U Máu Gan

“…Mặc dù, tiêu chuẩn chẩn đoán hình ảnh u máu gan là khá rõ ràng và dễ nhận ra, nhưng không phải tất cả các u máu gan đều có biểu hiện đặc trưng hoặc điển hình trên hình ảnh. Đôi khi, những tổn thương này có biểu hiện không điển hình và có thể bị nhầm lẫn với các tổn thương ác tính khác như ung thư biểu mô tế bào gan, ung thư đường mật trong gan, ung thư biểu mô tế bào gan-đường mật hỗn hợp [3].…”

“…Nghiên cứu của chúng tôi thấy rằng tuổi trung bình của các bệnh nhân là 54,7 ± 17,1. Nghiên cứu của Liu, Z. có tuổi trung vị là 45, độ tuổi dao động từ 24-62 [3]. Tỷ lệ giới tính giữa nữ và nam được báo cáo là khác nhau, từ thấp 1,2:1 tới cao là 6:1 [4].…”

“…Tỉ lệ nữ giới trong nghiên cứu này là 55,1% cũng cao hơn nam giới. Tác giả Liu, Z. cũng thấy tỉ lệ nam:nữ là 11:14 [3].…”