Primary Hepatic Angiosarcoma: A Case Report with 10-Year Patient Medical Data

Abstract

In the current study, we report a case of a 46-year-old man who presented with sudden abdominal pain and was diagnosed with rupture of hepatic angiosarcoma (HAS). He underwent surgery, but died 13 days after the onset of the abdominal pain. Chronic exposure to carcinogens, such as thorium dioxide, arsenic, vinyl chloride, and radium, is associated with HAS. However, our patient had not been exposed to such carcinogens. He had submitted himself for annual medical checkups since he was employed. His liver was cirrhotic, and medical history data showed that he had had fatty liver for at least 10 years before HAS onset. Although liver cirrhosis may play a role in the occurrence of HAS, the connection of chronic fatty liver in the tumorigenesis remains unclear. Case reports regarding HAS with fatty liver are few. To the best of our knowledge, this is the first case of HAS occurring in a cirrhotic liver that advanced from persistent fatty stage. Given that HAS is a rare tumor, data collection is important for investigating its pathophysiology. Case presentations considering health conditions before HAS onset are limited; therefore, we present a case of HAS with annual health checkup data before disease onset.

Hepatic angiosarcoma in an adult who had Wilms tumor treated in childhood: A case report

“…The prognosis for patients with liver angiosarcoma is extremely grim with mean survival around 6 months due to early distant metastasis to other organs such as the lungs, spleen, and colon [ [9] , [10] , [11] ]. There are some environmental risk factors linked to liver angiosarcomas such as the use of an oral contraceptive pill or anabolic steroids, radiation exposure, arsenic, vinyl chloride, and Thorotrast (a suspension of radioactive compound thorium dioxide, that was used as a radiocontrast agent until 1950s) which contribute to increasing the incidence of hepatic angiosarcoma [ 12 , 13 ]. Diagnosis of hepatic angiosarcoma is challenging since patients usually present with nonspecific symptoms including right upper quadrant abdominal pain, weight loss, fever, and fatigue.…”

Hepatic Angiosarcoma in a Patient with Liver Cirrhosis

“…Immunohistochemical staining is useful for confirmation, usually expressing CD34, CD31 and factor VIII-related antigen [7]. Differential diagnosis must con-most frequent mesenchymal malignancy of the liver [1,2]. It originates from liver vascular endothelial cells and lymphatic vessels cells [1].…”

“…HAS is associated with exposure to chemical carcinogens, including vinyl chloride, radiocontrast material, thorium dioxide, androgenic steroid and arsenic [1,2,4].…”

“…Reports regarding the association of HAS with cirrhosis have thrown contradictory findings. Some studies suggest the comorbidity of the two of them, but whether playing a direct causative role or just coexisting is not clear [2,4]. Others, argue against the association.…”

“…Hepatic angiosarcoma (HAS) is a rare malignancy that accounts for 2% of all hepatic primary tumors [1]. It has been related to exposure to carcinogens (vinyl chloride, radiocontrast material, thorium dioxide, androgenic steroid, arsenic...) [1,2]. The diagnosis is challenging due to the lack of specificity of the symptoms and the heterogeneous appearance on radiologic images, especially if the patient does not have previous history of occupational exposure.…”