A Case of Hemangiosarcoma of the Liver which led to a Diagnosis with Hemoptysis

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type:Case Report

Angiosarcoma is a vascular endothelium-derived malignant tumor that arises in blood vessel walls, accounting for only 2.3% of soft tissue sarcomas in adults. Primary hepatic angiosarcoma(PHA)is rare, comprising< 5% of all angiosarcomas. We report a case of PHA in a 61-year-old man evaluated by another clinic around our hospital for a chief complaint of hemoptysis in May 2012. Chest computed tomography(CT) showed abnormal shadows in bilateral lung fields, so he was referred to Department of Respiratory Medicine at our hospital in late July. However, no definitive diagnosis was not made, even after bronchoscopy. In mid-August, he presented to the outpatient clinic of the respiratory department with a chief complaint of right-sided abdominal pain. Abdominal CT showed a liver lesion, and he was urgently admitted to our department. Initial physical examination was unremarkable except for palpable liver in the right hypochondrium. Tumor markers for liver and biliary cancers were all within normal limits, and negative results were obtained for hepatitis B and C virus. CT, ultrasonography, and(MRI)identified a large lesion replacing the right hepatic lobe and medial segment of the left hepatic lobe. Hemangioma or hepatic angiosarcoma was suspected, accompanied by intraperitoneal rupture. Transcatheter arterial embolization was attempted, but had to be discontinued, and the patient died from hemorrhagic shock due to tumor rupture after onset of abdominal pain. The PHA which assumes hemoptysis primary symptom is extremely rare, and by reports for the past ten years searched using PubMed, this is the second report in the world.

identifier:7

identifier:KJ00009786644

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