Skip to main content
SpringerLink
Log in

Clinical Manifestations of Primary Hepatic Angiosarcoma

  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

Malignant tumors of the liver stemming from mesenchymal origins are rare neoplasms, <1% of primary malignant hepatic lesions. Primary hepatic angiosarcoma (PHA) is the most common (36%). This study describes the incidence and clinical characteristics of this rare tumor in two medical centers, over the past 18 years. We reviewed tumor registry files at Jackson Memorial Hospital and oncology data records at Cedar's Medical Center, 1979–1997. A total of 865 primary hepatic tumors were identified, of which five cases (0.58%) were PHA; four were men, and the median age was 53 years. Symptoms and signs included: pain, anemia, fever of unknown origin, weight loss, abdominal mass, and hemoperitoneum. Median survival was only 6 months. In conclusion, primary hepatic angiosarcomas frequently are symptomatic. The presentation and preexisting factors are valuable in establishing a clinical suspicion to diagnose this rare tumor. Although imaging studies are helpful, they are not conclusive, and liver biopsy is usually required.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Norifumi N, Masahiko O, Yasuhiko T, Hiroyuki K, Atsumasa U, Katsuyuki A: Angiosarcoma in Japan. Cancer 75(4):989-996, 1995

    Google Scholar 

  2. Rufus M, Joseph P, Luu T, Yao F, Guy J: Angiosarcoma: A report of 67 patients and review of the literature. Cancer 77(11):2400-2406, 1996

    Google Scholar 

  3. Alrenga D: Primary angiosarcoma of the liver. Integrated Surg 60(4):198-203, 1975

    Google Scholar 

  4. Heath CW Jr, Falk H, Creech JL Jr: Characteristics of cases of angiosarcoma of the liver among vinyl chloride workers in the United States. Ann NY Acad Sci 246:231-236, 1975

    Google Scholar 

  5. Trivers GE, Cawley HL, De Benedetti VM, Hollstein M. Marion MJ, Bennett WP, Hoover ML, Prives CC, Tamburro CC, Harris CC: Anti-p53 antibodies in sera of workers occupationally exposed to vinyl chloride. J Nat Cancer Inst 87(18):1400-1407, 1995

    Google Scholar 

  6. Anon: Epidemiologic notes and reports. Angiosarcoma of the liver among polyvinyl chloride workers—Kentucky. MMWR 46(5)97-101, 1997

    Google Scholar 

  7. Falk H, Herbert J, Crowley S, Ishak K, Thomas L, Popper H, Caldwell G: Epidemiology of hepatic angiosarcoma in the United States: 1964–1974. Environ Health Perspect 41:107-113, 1981

    Google Scholar 

  8. Locker GY, Doroshow JH, Zwelling LA, Chabner BA: The clinical features of hepatic angiosarcoma: a report of four cases and a review of the English literature. Medicine 58(1):48-64, 1979

    Google Scholar 

  9. Kojiro M, Nakashima T, Ito Y, Ikezaki H, Mori T, Kido C: Thorium dioxide-related angiosarcoma of the liver. Arch Pathol Lab Med 109:853, 1985

    Google Scholar 

  10. Grampa G: Radiation injury with particular reference to thorotrast. Pathol Ann 6:147-169, 1971

    Google Scholar 

  11. Harrison R: Vinyl chloride monomer and polyvinyl chloride. Primary Care Clin Office Pract 27(4):917-982, 2000

    Google Scholar 

  12. Creech J, Johnson M: Angiosarcoma of liver in the manufacture of polyvinyl chloride. J Occup Med 16(3):150-151, 1974

    Google Scholar 

  13. Hozo I, Miric D, Bojic L, Guinio L, Culic V, Simunic M: Liver angiosarcoma and hemangiopericytoma after occupational exposure to vinyl chloride monomer. Environ Health Perspect 108(8):793-795, 2000

    Google Scholar 

  14. Lelbach W: A 25-year follow-up study of heavily exposed vinyl chloride workers in Germany. Am J Ind Med 29:446-456, 1996

    Google Scholar 

  15. Rosenthal AK, Klausmeier M, Cronin ME, McLaughlin JK: Hepatic angiosarcoma occurring after cyclophosphamide therapy: case report and review of the literature. Am J Clin Oncol 23(6):581-583, 2000

    Google Scholar 

  16. Daneshemend TK, Scott GL, Bradfield JWB: Angiosarcoma of liver associated with phenelzine. BMJ 1:1679, 1979

    Google Scholar 

  17. Monroe PS, Riddell RH, Siegler M, Baker AL: Hepatic angiosarcoma. Possible relationship to long term oral contraceptive ingestion. JAMA 246:64-65, 1981

    Google Scholar 

  18. Falk H, Popper H, Thomas L, Ishak K: Hepatic Angiosarcoma Associated with Androgenic-Anaboli Steroids. Lancet 0:1120-1123, 1979

    Google Scholar 

  19. Andreu V, Elizalde I, Mallafre C, Caballeria J, Salmeron J, Sans M, Mas A, Bruguera M, Rodes J: Plexiform neurofibromatosis and angiosarcoma of the liver in von Recklinghausen disease. Am J Gastroenterol, 92(7):1229-1230, 1997

    Google Scholar 

  20. Baxter P: The British hepatic angiosarcoma register. Environ Health Perspect, 41:115-116, 1981

    Google Scholar 

  21. Lee F, Smith PM, Bennett B, Williams DMJ: Occupationally related angiosarcoma of the liver in the United Kingdom 1972–1994. Gut 39(2):312-318, 1996

    Google Scholar 

  22. Burke M, Opeskin K: Spontaneous rupture of liver associated with a primary angioscarcoma: case report. Am J Forens Med Pathol 21(2):134-137, 2000

    Google Scholar 

  23. Lee C, Chung Y, Lee G, et al: A case of giant hemangioma of the liver presenting with fever of unknown origin. J Kor Med Sci 9(2):200-2004, 1994

    Google Scholar 

  24. Buetow P, Buck J, Ros P, Goodman Z: Malignant vascular tumors of the liver: Radiologic—pathologic correlation. Radiographics 14:153-159, 1994

    Google Scholar 

  25. Peterson MS, Baron RL, Rankin SC: Hepatic angiosarcoma: findings on multiphasic contrast-enhanced helical CT do not mimic hepatic hemangioma. Am J Roentgenol 175(1):165-170, 2000

    Google Scholar 

  26. White PG, Adams H, Smith PM: The computed tomographic appearances of angiosarcoma of the liver. Clin Radiol 48:321-325, 1993

    Google Scholar 

  27. Ohmoto K, Hirokawa M, Takesue M, Yamamoto S: Hepatic angiosarcoma with early central enhancement and atrerioportal shunt on dynamic CT. Hepato-Gastroenterol 47(36):1717-1718, 2000

    Google Scholar 

  28. Ginsberg F, Slavin J, Spencer R: Hepatic angiosarcoma: mimicking of angioma on three-phase technetium-99m red blood cell scintigraphy. J Nucl Med 27(12):1861-1863

  29. Katayama N, Inoue Y, Harada M, Ichikawa T, Shimoyamada K, Ikeda M, Itoh T, Tsukune Y: False-negative blood pool scan in hepatic angiosarcoma. Clin Nucl Med 23(5):321-322, 1998

    Google Scholar 

  30. Drinkovic I, Brkljacic B: Two cases of legal complications following ultrasound-guided percutaneous fine-needle biopsy of the liver. Cardiovasc Intervent Radiol 19(5):360-363, 1996

    Google Scholar 

  31. Hertzanu Y, Peiser J, Zirkin H: Massive bleeding after fine needle aspiration of liver angiosarcoma. Gastroenterol Radiol 15:43-46, 1990

    Google Scholar 

  32. Saleh H, Tao LC: Hepatic angiosarcoma: aspiration biopsy cytology and immunocytochemical contribution. Diagn Cytopathol 18(3):208-211, 1998

    Google Scholar 

  33. Luo JC, Liu HT, Cheng TJ, Du CL, Wang JD: Pasma p53 Protein and anti-p53 antibody expression in vinyl chloride monomer workers in Taiwan. J Occup Environ Med 41(6):521-526, 1999

    Google Scholar 

  34. Smith S, Li Y, Whitley R, Marion M, Partilo S, Carney W, Brandt P: Molecular epidemiology of p53 protein mutations in workers exposed to vinyl chloride. Am J Epidemol 147(3): 302-308, 1998

    Google Scholar 

  35. McDonagh DP, Liu J, Gaffey MJ, Layfield LJ, Azumi N, Traweek T: Detection of Kaposi's sarcoma-associated herpesvirus-like DNA sequence in angiosarcoma. Am J Pathol 149(4):1363-1368, 1996

    Google Scholar 

  36. Ishak KG, Bijwaard KE, Markhlouf HR, Taubenberger JK, Lichy JH, Goodman ZD: Absence of human herpesvirus 8 DNA sequences in vascular tumors of the liver. Liver 18:124-127, 1998

    Google Scholar 

  37. Dannaher C, Tamburro C, Yam L: Chemotherapy of vinyl chloride-associated hepatic angiosarcoma. Cancer 47:466-469, 1981

    Google Scholar 

  38. Tamburro C: Relationship of vinyl monomers and liver cancers: angiosarcoma and hepatocellular carcinoma. Semin Liver Dis 4(2):158-169, 1984

    Google Scholar 

  39. Timaran CH, Grandas OH, Bell JL: Hepatic angiosarcoma: long-term survival after complete surgical removal. Am Surg 66(12):1153-1157, 2000

    Google Scholar 

  40. O'Grady JG: Treatment options for other hepatic malignanies. Liver Transplant 6(suppl 2):S23-S29, 2000

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Center for Liver Diseases, University of Miami School of Medicine, 1500 N.W. 12 Ave, Suite 1101, Miami, Florida, 33136, USA

    Enrique Molina & Alfredo Hernandez

Authors
  1. Enrique Molina
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alfredo Hernandez
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Molina, E., Hernandez, A. Clinical Manifestations of Primary Hepatic Angiosarcoma. Dig Dis Sci 48, 677–682 (2003). https://doi.org/10.1023/A:1022868221670

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1022868221670

Search

Navigation