Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 6, 2022; 10(31): 11590-11596
Published online Nov 6, 2022. doi: 10.12998/wjcc.v10.i31.11590
Primary hepatic angiosarcoma: A case report
Jian Wang, Li-Tao Sun
Jian Wang, Li-Tao Sun, Cancer Center, Department of Ultrasound Medicine, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou 310014, Zhejiang Province, China
Author contributions: Wang J drafted the manuscript; Sun LT revised the manuscript.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment. The patient provided informed written consent for the publication of this case report.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
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: Li-Tao Sun, PhD, Doctor, Cancer Center, Department of Ultrasound Medicine, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, No. 158 Shangtang Road, Gongshu District, Hangzhou 310014, Zhejiang Province, China. litaosun1971@sina.com
Received: June 30, 2022
Peer-review started: June 30, 2022
First decision: August 1, 2022
Revised: August 17, 2022
Accepted: September 23, 2022
Article in press: September 23, 2022
Published online: November 6, 2022
Processing time: 118 Days and 16.5 Hours
Abstract
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 low-density 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.

Keywords: Primary hepatic angiosarcoma; Ultrasonic diagnosis; Imaging; Pathology; Case report

Core Tip: In this study, we showed a rare reported disease named primary hepatic angiosarcoma (PHA). In this case report, we focused on diagnosing PHA by contrast-enhanced ultrasound (CEUS). Meanwhile, we introduced a new ultrasound technology, and CEUS has many specific signs in the diagnosis and differential diagnosis of PHA. It has great advantages in displaying microperfusion, microvessels and necrosis of PHA and has great clinical value in diagnosing PHA. Our findings regarding CEUS contribute to the more accurate and earlier diagnosis of PHA and provide a longer survival time in the future.