Hepatic angiosarcoma as a cause of acute liver failure

Abstract

Hepatic angiosarcoma is an extremely rare disease entity that accounts for approximately 0.1%-2% of primary liver malignancy. It is three times more common in men than women and usually affects the former in their sixth or seventh decade of life. Risk factors for the development of hepatic angiosarcoma include the use of oral contraceptives, exposure to anabolic steroids, radiation, thorium dioxide, arsenic and vinyl chloride. The prognosis of hepatic angiosarcoma is extremely poor which is attributable to early metastases to other organs, resistance to traditional chemotherapy and radiotherapy regimens and rapid progression of the tumour. Optimal management of patients is poorly demarcated due to the rarity of the tumour. We present a case series of two patients: one who passed away due to acute hepatic failure secondary to hepatic angiosarcoma and the second who underwent a liver transplantation and was subsequently diagnosed with hepatic angiosarcoma based on his explant histology.

Hepatic Angiosarcoma with Peliosis Hepatis

“…The association between hepatic angiosarcoma and peliosis hepatis remains unclear. Anabolic steroids have been reported to be a common cause of both diseases ( 31 , 43 ). In the present case, some dietary supplements with steroid effects were consumed by the patient.…”

Hepatic angiosarcoma in an adult who had Wilms tumor treated in childhood: A case report

“…It accounts for 1-2% of primary liver tumors, which occur 3 times more often in men than women in their sixth or seventh decade of life. The prognosis for patients with liver angiosarcoma is extremely grim with mean survival around 6 months due to early distant metastasis to other organs such as the lungs, spleen, and colon [ [9] , [10] , [11] ]. There are some environmental risk factors linked to liver angiosarcomas such as the use of an oral contraceptive pill or anabolic steroids, radiation exposure, arsenic, vinyl chloride, and Thorotrast (a suspension of radioactive compound thorium dioxide, that was used as a radiocontrast agent until 1950s) which contribute to increasing the incidence of hepatic angiosarcoma [ 12 , 13 ].…”

Clinical characteristics of primary hepatic angiosarcoma outcomes: a SEER database analysis

“…PHA has no specific etiologic agent in most patients, while exposure to vinyl chloride and ionizing radiation may be important risk factors (4,5). Clinically, PHA shows various symptoms, such as abdominal pain, anorexia, fatigue, weight loss, fever, low back pain, jaundice, hemoperitoneum and acute Original Article Clinical characteristics of primary hepatic angiosarcoma outcomes: a SEER database analysis hepatic failure, although these symptoms are nonspecific (6,7). Often, no specific symptoms are observed, and the levels of tumor markers are usually not elevated in the early stages of the disease, such as alpha fetoprotein (AFP), carcinoembryonic antigen (CEA), cancer antigen 19-9 (CA19-9), and cancer antigen 125 (CA125), making PHA difficult to diagnose (8).…”