A complementary comment on primary hepatic angiosarcoma:A case report

BACKGROUND This article examines primary hepatic angiosarcoma(PHA)and fat-poor angiomyolipoma(AML),two uncommon vascular cancers.Clinical decisions in these situations are frequently aided by pathology reports and imaging techniques.Uncommon malignant tumors of the vascular endothelium include PHA.Another diagnosis that should not be overlooked when employing contrastenhanced MR and contrast-enhanced computed tomography(CT)imaging techniques is fat-poor AML,one of the uncommon vascular tumors of the liver.In both conditions,biopsy is the primary means of diagnosis.CASE SUMMARY In our article,besides the diagnosis of PHA,fat-poor AML,one of the other rare vascular tumors of the liver,is mentioned.In the case,a 50-year-old female patient with VHL Syndrome was admitted to our hospital with nonspecific lesions such as right upper quadrant pain,weight loss,and nausea.Abdominal ultrasonography(US)revealed a hypoechoic heterogeneous lesion with occasional faint contours.In computed tomography,it was observed as a hyperdense nodular lesion in segment 4.Magnetic resonance imaging(MRI)revealed that the lesion did not contain fat.In connection with the known history of VHL Syndrome,we first evaluated the possibility of AML.Thereupon,a histopathological sample was taken and the diagnosis was made as fat-poor AML with 5%fat content.CONCLUSION In conclusion,PHA in our case report and fat-poor AML in our clinic are two uncommon liver vascular malignancies with comparable incidences.Important imaging techniques like contrast-enhanced US(CEUS),CECT,and CEMRI give us substantial advantages in both cases.However,a biopsy is used to provide the final diagnosis.

Primary hepatic angiosarcoma: A case report

BACKGROUND Primary hepatic angiosarcoma(PHA)is a rare malignant tumor of the vascular endothelium.Clinical manifestations and laboratory and imaging examinations often lack specificity for PHA.We report a case of PHA,and describe the ultrasound characteristics and characteristic changes in laboratory values associated with PHA.CASE SUMMARY A 75-year-old woman presented with right upper quadrant abdominal pain for half a month.Magnetic resonance imaging(MRI)at a local hospital revealed multiple liver space-occupying lesions,and she was admitted to our hospital for further diagnosis.Contrast-enhanced ultrasound(CEUS)revealed multiple slightly hyperechoic nodules in the liver,which were suspected to be of malignant vascular origin.Contrast-enhanced computed tomography revealed multiple lowdensity nodules in the liver,considered to be metastatic hematopoietic malignancies.Contrast-enhanced MRI showed that the multiple liver nodules shared features with infectious lesions.Laboratory examination revealed normal alpha-fetoprotein levels,slightly increased other liver enzymes,decreased platelets,and significantly increased D-dimer levels.Liver biopsy and histopathology confirmed the presence of PHA.CONCLUSION CEUS can provide valuable clues for the diagnosis of PHA and greatly improve the success rate of puncture biopsy.