Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 16, 2023; 11(8): 1814-1822
Published online Mar 16, 2023. doi: 10.12998/wjcc.v11.i8.1814
A complementary comment on primary hepatic angiosarcoma: A case report
Ali Osman Gulmez, Sonay Aydin, Mecit Kantarci
Ali Osman Gulmez, Sonay Aydin, Mecit Kantarci, Department of Radiology, Erzincan University, Erzincan 24100, Turkey
Author contributions: Gulmez AO and Aydin S contributed equally to this work; Gulmez AO, Aydin S, and Kantarci M designed the research study; Gulmez AO carried out the research; Aydin S contributed new reagents and analytical tools; Kantarci M analyzed the data and wrote the draft; all authors have read and approved the final draft.
Informed consent statement: Informed written consent was obtained from the patients for the publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
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Corresponding author: Ali Osman Gulmez, MD, Doctor, Department of Radiology, Erzincan University, Mengucek Gazi Education and Research Hospital, BaşbağlarMahallesiHacı Ali Akın Caddesi No. 32 Erzincan/Merkez, Erzincan 24100, Erzincan 24100, Turkey. aliosmangulmez.2@gmail.com
Received: November 17, 2022
Peer-review started: November 17, 2022
First decision: November 25, 2022
Revised: December 1, 2022
Accepted: January 20, 2023
Article in press: January 20, 2023
Published online: March 16, 2023
Processing time: 109 Days and 21.3 Hours
Abstract
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 contrast-enhanced 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.

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

Core Tip: In this review, two rare vascular tumors, namely primary hepatic angiosarcoma (PHA) and fat-poor angiomyolipoma (AML), were mentioned. Special mention is made of the diagnosis of PHA by contrast-enhanced ultrasound (CEUS) in these case reports. Meanwhile we introduced a new ultrasound technology and CEUS has many specific manifestations in the diagnosis and differential diagnosis of PHA and has great clinical value in diagnosing PHA. Although imaging methods have an important place in the diagnosis of fat-poor AML, one of the points especially mentioned in the study is that the definitive diagnosis of both tumors will be made with a pathology report after biopsy.