Hepatic angiosarcoma arising in an adult mesenchymal hamartoma

Abstract

The histogenesis of the hepatic sarcoma and its association with hamartoma is not well understood. We hereby present a Chinese patient with hepatic angiosarcoma arising from an adult mesenchymal hamartoma of liver. A 33-yr-old woman was diagnosed hepatic hamartoma eight years ago and presented with epigastric distention recently. Now she was admitted to our hospital with some unusual features: (a) this patient was diagnosed in mid-twenties, (b) the tumor occupied the whole liver and most importantly (c) the hepatic angiosarcoma appeared 8 years after the diagnosis of hamartoma. Based on this case and some reports, hepatic hamartoma may develop to hepatic angiosarcoma.

Figure 1

Unenhanced spiral CT scan showed liver with rugositied surface, multinodular focuses involved the whole liver, calcified plaques and ascites.

Figure 2

Haematoxylin and eosin stain (×400); typical features of hepatic angiosarcoma including sinusoidal and spindle-shape growth of the malignant endothelial cells, atrophy of liver cells and disruption of the hepatic plates.

Figure 3

Haematoxylin and eosin stain (×400); mesenchymal hamartoma with spindle and stellate cells in the mucoid matrix.

Figure 4

Immunohistochemistry of CD34 in angiosarcoma (streptavidin peroxidase method, ×400) immunoreactivity mainly localized to the cytoplasm of malignant cells.

Figure 5

Immunohistochemistry of Vimentin in angiosarcoma (streptavidin peroxidase method, ×400) immunoreactivity mainly localized to the cytoplasm of malignant cells.