Surgically Diagnosed Primary Hepatic Angiosarcoma

Abstract

Primary hepatic angiosarcoma is a rare tumor originating from endothelial cells in the liver and accounts for approximately 1% of all hepatic malignant tumors. It is difficult to diagnose due to the lack of specific symptoms or tumor markers. No effective treatment exists, but complete surgical resection may achieve a good outcome. Since most primary hepatic angiosarcomas are already at an advanced stage at diagnosis, few reports describe tumors smaller than 2 cm. We report a case of surgery for a 1.7-cm sized primary hepatic angiosarcoma. Further studies are required to improve the preoperative diagnosis of primary hepatic angiosarcoma.

Keywords: diagnosis; hemangiosarcoma; hepatosarcoma; primary hepatic angiosarcoma; surgical resection.

Figure 1.

Computed tomography and magnetic resonance imaging (MRI) of the abdomen (transverse scan). The lesion showed no enhancement in the arterial phase (a), portal vein phase (b), or delayed phase (c). Dynamic MRI also revealed a single non-enhanced tumor in the arterial phase (d) and hepatocellular phase (e). The tumor showed a high signal intensity on diffusion weighted imaging (f).

Figure 2.

The macroscopic and histological findings. A macroscopic image of the 1.7-cm sized tumor of the right lobe of the liver (a) and the histological features (b) of the tumor (Hematoxylin and Eosin staining; original magnification, ×400).

Figure 3.

Immunohistochemical staining. The hepatic angiosarcoma components were positive for CD31 (a) and CD34 (b), negative for Hep-par 1 (c), glypican 3 (d), AE1/AE3 (e), and CK7 (f) (original magnification, ×200).