Five years and 4 months of recurrence-free survival in hepatic angiosarcoma

Abstract

A 54-year-old woman was referred with the diagnosis of hepatic angiosarcoma, made by percutaneous biopsy under ultrasonographic guidance. Ultrasonography (US) had revealed a 48 x 42 x 35 mm mass in the right lobe. Standard biochemical tests and whole blood count had yielded normal results. At our institution, magnetic resonance imaging demonstrated a hypervascular mass in the right lobe. Alpha-fetoprotein, carcinoembryonic antigen, and carbohydrate antigen 19-9 levels were normal. Serological tests were negative for hepatitis B and C viruses. There was no evidence of metastasis. A right hepatectomy was performed. Histopathological examination confirmed the diagnosis of angiosarcoma. However, there was a suspicion of microscopically positive margins. Relaparotomy and resection of a 1-cm-thick slice of hepatic parenchyma was performed. Histopathological examination revealed necrotic tumor cells at the previous margin. The new surgical margin was tumor free. Due to the expected poor prognosis, prophylactic chemoembolization of the remnant liver (lipiodol + adriamycin + mitomycin) was performed at 3 and 7 months postoperatively. She has been alive without recurrence for 5 years and 4 months. Hepatic angiosarcoma has two distinct presentations: multiple tumors and a solitary tumor. The reported poor results largely stem from the predominance of the multiple tumors and consequent unresectability. Long-term survival is possible in solitary resectable hepatic angiosarcomas.

The Natural History of a Hepatic Angiosarcoma that was Difficult to Differentiate from Cavernous Hemangioma

“…We also performed emergent TAE of the present ruptured mass twice. Given the poor prognoses of patients with hepatic angiosarcoma, surgical resection is the only definitive treatment (2). Even with complete tumor resection, recurrence of hepatic angiosarcoma is common and most patients die within 11 months (7).…”

“…They progress rapidly and are associated with a poor prognosis and a six months median survival rate without treatment (1). Complete tumor resection is the treatment of choice for nonmetastatic disease (2). However, curative surgery often cannot be performed due to delayed diagnosis of metastatic disease.…”

Hepatic angiosarcoma five years following spontaneous intraperitoneal bleed of a hepatic mass

“…2 Given the poor prognosis for patients diagnosed with hepatic angiosarcoma, surgical resection is the only definitive treatment; however, this is not possible in many cases either because of multifocal disease or the extent of the liver involvement. 6 Adjuvant treatment remains undefined owing to the rarity of the tumor. Chemotherapy has not been well studied except on a case report basis, and in general angiosarcomas are resistant to radiation therapy.…”

Statistics and outlook of primary hepatic angiosarcoma based on clinical stage

“…In addition, 6 cases from Tri-Service General Hospital were included. Finally, 34 patients in 16 case reports and from our hospital were enrolled in the analysis (10,(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27). The mean age at diagnosis was 58.9 years (range, 29-83 years).…”