摘要
OBJECTIVE Hepatic angiosarcoma (HAS), a lethal disease, is the most common sarcoma arising in the liver. Little information about the epidemiology, etiology, diagnosis and management of HAS has been reported. Increased familiarity with this disease will facilitate correct diagnosis and help to improve management of this condition in the future.The objective of this study was to describe cases of hepatic angiosarcoma and to discuss the etiologic, diagnostic, therapeutic features and prognosis of this tumor. This report not only serves to give more evidence of the relationship between hepatic angiosarcoma and carcinogenic exposure, but also demonstrates the key points in different methods of diagnosis and the optimal treatment of hepatic angiosarcoma.METHODS Twelve cases of hepatic angiosareoma were analyzed retrospectively, representing the different character in clinical presentations and laboratory computed tomographical scans; pathological data and treatment are described. Clinical and biologic follow-up was carried out fortwo years after surgical treatment.RESULTS There were nine men and three women varying in ages from 57 to 71 years with an average of 64.3 years. Ten patients had a history of exposure to vinyl chloride or thorotrast. Mild or moderate abdominal pain and bloating, abdominal mass and fever were the common clinical presentations. Tumors were visualized by ultrasonography and CT scans in all patients. Biochemical profiles yielded variable results and proved to be of little value in detection or diagnosis. Surgical resection was feasible for each patient who was treated as follows: two wedge resections, six segementectomies and four bisegmentectomies. Five patients received Neoadjuvant chemotherapy postoperatively. The survival rate of those cases was poor. The maximum survival time was fourteen months. The mean survival time for this chemotherapeutic group was 11 months. The difference between the survival time of those treated with an operation plus chemotherapy versus only an operation was significant (P=0.0086, <0.05).CONCLUSION Hepatic angiosarcoma, progressing rapidly after diagnosis,has a poor prognosis. The relationship between the development of hepatic angiosarcoma and the long period of exposure to carcinogens is presented in this report. CT imaging has some specific importance in diagnosis. The diagnosis of the lesion was dependent upon the pathologic data. Complete resection may be the only effective therapy for primary hepatic angiosarcoma at present. Better adjuvant chemotherapy is necessary to increase the survival rate of this disease.
