Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. May 15, 2022; 14(5): 1050-1056
Published online May 15, 2022. doi: 10.4251/wjgo.v14.i5.1050
Primary hepatic angiosarcoma manifesting as hepatic sinusoidal obstruction syndrome: A case report
Fu-Shuang Ha, Hua Liu, Tao Han, De-Zhao Song
Fu-Shuang Ha, Hua Liu, Tao Han, De-Zhao Song, The Third Central Clinical College of Tianjin Medical University, Tianjin 300170, China
Fu-Shuang Ha, Hua Liu, Tao Han, De-Zhao Song, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin 300170, China
Fu-Shuang Ha, Hua Liu, Tao Han, De-Zhao Song, Artificial Cell Engineering Technology Research Center, Tianjin 300170, China
Fu-Shuang Ha, Hua Liu, Tao Han, De-Zhao Song, Tianjin Institute of Hepatobiliary Disease, Tianjin 300170, China
Tao Han, Tianjin Union Medical Center, Naikai University Affiliated Hospital, Tianjin 300121, China
Author contributions: Ha FS and Liu H contributed equally to this work; Ha FS and Liu H wrote the original draft; Song DZ performed the transjugular liver biopsy; Han T reviewed and edited the manuscript; all authors have read and approved the final manuscript.
Supported by Tianjin Science and Technology Plan Project, No. 19ZXDBSY00030; and Beijing iGandan Foundation, No. RGGJJ-2021-014.
Informed consent statement: The patient and his legal guardian provided informed written consent prior to the case report.
Conflict-of-interest statement: Nothing to disclosed.
CARE Checklist (2016) statement: The authors have read the CARE checklist (2016), and the manuscript was prepared and revised according to the CARE checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Tao Han, MD, PhD, Professor, The Third Central Clinical College of Tianjin Medical University, No. 83 Jintang Road, Tianjin 300170, China. hantaomd@126.com
Received: November 27, 2021
Peer-review started: November 27, 2021
First decision: January 8, 2022
Revised: January 20, 2022
Accepted: April 20, 2022
Article in press: April 20, 2022
Published online: May 15, 2022
Abstract
BACKGROUND

Primary hepatic angiosarcoma (PHA) is a rare malignancy with a poor prognosis. It is difficult to diagnose PHA because of the lack of specific symptoms or tumour markers, and it rapidly progresses and has a high mortality. To our knowledge, PHA has not been reported to mimic hepatic sinusoidal obstruction syndrome. Herein, we present a case of PHA manifesting as hepatic sinusoidal obstruction syndrome, diagnosed using transjugular liver biopsy, that resulted in the death of the patient.

CASE SUMMARY

A 71-year-old man was admitted with the primary complaint of abdominal distension, decreased appetite, fatigue in the previous month, and loss of 10 kg of weight in the past 2 years. Both the liver and spleen were enlarged, and the liver had a medium-hard texture on percussion. Laboratory examinations were performed, and abdominal plain computed tomography (CT) and contrast-enhanced CT showed hepatomegaly and splenomegaly, as well as diffuse low-density shadows distributed in the liver and spleen. Contrast-enhanced CT revealed diffuse, hypodense, nodular or flake shadows in the liver and heterogeneous enhancement in the spleen. A transjugular liver biopsy was performed. Based on the pathology results, the patient was diagnosed with hepatic sinusoidal obstruction syndrome secondary to PHA. The patient’s status further deteriorated and he developed serious hepatic failure. The patient was discharged, and died 3 d later.

CONCLUSION

PHA is rare and has a poor prognosis; however, transjugular liver biopsy can be safely performed to aid in diagnosis.

Keywords: Hepatic angiosarcoma, Hepatic sinusoidal obstruction syndrome, Outcome, Primary cancer, High mortality, Case report

Core Tip: To our knowledge, primary hepatic angiosarcoma (PHA) has not been reported to mimic hepatic sinusoidal obstruction syndrome. Here, we present a patient who died from PHA, which manifested as hepatic sinusoidal obstruction syndrome and was diagnosed by transjugular liver biopsy.