Hepatic Angiosarcoma

Hepatic angiosarcoma (also malignant hemangioma of liver, hepatic endothelial sarcoma, Kupffer cell sarcoma, hemangioendothelial sarcoma, malignant hemangioendothelioma) is the most common primary hepatic sarcoma in Western countries; a rare primary malignancy arising from atypical proliferation of hepatic sinusoidal cells. Age 50-70; M:F ~3-4:1.

Common Symptoms

Abnormal liver function; abdominal discomfort; acute abdomen; weight loss; anorexia; ascites; abdominal pain; fatigue; nausea

Causes and Pathogenesis

(1) Etiology: mesenchymal tumor, highly malignant. 75% idiopathic. Linked to vinyl chloride (latency ~17y, 7/1183 workers in one US plant); synthetic steroids/estrogens/oral contraceptives (>10y latency); inorganic arsenic in drinking water/pesticides; radiation (radium, atomic bomb); potassium arsenate for psoriasis; other: radium, inorganic copper, MAO inhibitors; idiopathic hemochromatosis. (2) Pathology: multicentric, often both lobes; blood-filled cysts 1-15cm (usually 5cm); single round solid nodule; multinodular, well-circumscribed, unencapsulated; larger masses spongy, up to 3kg; thrombosis/secondary necrosis; cut surface gray-white/tan gel-like with hemorrhage/necrosis; large non-clotted blood-filled spaces; reticulin fibrosis (Thorotrast/vinyl chloride); splenomegaly; cirrhosis uncommon. Histology: spindle/irregular malignant endothelial cells; eosinophilic cytoplasm; hyperchromatic elongated nuclei; mitoses common; thin-walled veins; hematopoietic foci in ~50%; factor VIII-related antigen positive; proliferates along sinusoids causing hepatocyte atrophy/disruption; may occlude terminal hepatic veins/portal branches causing hemorrhage/infarction/necrosis; extra-medullary hematopoiesis; Thorotrast deposits in reticuloendothelial cells/portal tracts.

Treatment

Surgical, drug, supportive therapy

Preventive Measures

Avoid harmful chemical/radiation exposure; occupational protection.

Department to Visit

It is recommended to visit the Hepatology department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.