Metastatic Angiosarcoma of the Liver Preoperatively Presenting as Giant Hemangioma

Abstract

Background: Hepatic angiosarcomas are rare tumors most often associated with exposure to vinyl chloride or other carcinogens. Only a few cases have been published without such a history. Case Report: We report the case of a 73-year-old woman who was admitted to our medical department with unclear upper abdominal pain, thrombocytopenia and anemia. Both computed tomography and magnet resonance imaging revealed a giant hemangioma in the right liver with multiple small hemangiomas. To cure the problem of thrombocytopenia due to sequestration of blood cells in the hemangioma, we decided to resect the large tumor. Intraoperatively, however, the diagnosis of angiosarcoma with multiple metastases was made. The patient died 6 weeks after surgery. Conclusion: Problems in diagnosing angiosarcoma include the brief duration of antecedent symptoms, difficulties in radiological diagnosis, and patients without a history of professional exposure to carcinogens.

Impact on Liver Cancer Treatment of a First Erroneous Diagnosis of Hemangioma

“…In the few published reports on this topic, attention is mostly on the false diagnosis of malignancy in patients with a benign lesion [16]. In 1992, Shimizu et al [10] reported on 32 patients with benign lesions who were operated on with a false diagnosis of cancer; HA was the most frequent final diagnosis.…”

Procaine Hydrochloride Fails to Relieve Pain in Patients with Acute Pancreatitis

“…Recently the use of procaine as treatment option for pain relief in AP was recommended by the German consensus conferences on management of acute and chronic pancreatitis [3, 4, 5]. The rationale for the use of procaine is its local analgesic effect and its inhibitory effect on phospholipase A 2 catalytic activity, which is a critical enzyme in the pathogenesis of AP [11, 12]. However, there are no prospective trials proving any beneficial effect of intravenously administered procaine on pain in patients with AP.…”