Thorotrast-induced ruptured hepatic angiosarcoma

A pooled analysis of treatment and prognosis of hepatic angiosarcoma in adults

BACKGROUND

Hepatic angiosarcoma is a rare malignant vascular tumor presenting unique treatment challenges. The aim of the present study was to determine the treatment and prognosis of this entity.

DATA SOURCES

A systematic literature search was conducted using PubMed, Embase and Chinese Biomedical Literature database, to identify articles published from January 1980 to July 2017. Search terms were "hepatic angiosarcoma" and "liver angiosarcoma". Additional articles were retrieved through manual search of bibliographies of the relevant articles. Pooled individual data concerning the prognosis following various therapeutic modalities were analyzed.

RESULTS

A total of 75 articles involving 186 patients were eligible for inclusion. The median overall survival (OS) was 8 months, with 1-, 3-, and 5-year OS rates of 36.6%, 22.3%, and 12.0%, respectively. The median OS after partial hepatectomy (n = 86), chemotherapy (n = 36), liver transplantation (n = 17), and supportive care (n = 46) were 15, 10, 5 and 1.3 months, respectively. Small tumor size (<10 cm) was the only significant favorable factor for OS after partial hepatectomy (P = 0.012).

CONCLUSIONS

Despite the dismal prognosis, partial hepatectomy could prolong the survival of hepatic angiosarcoma patients, particularly those with tumors <10 cm. Chemotherapy could be an option for unresectable disease. Liver transplantation is not a recommendable option for the management of this malignancy.

Current imaging strategies of primary and secondary neoplasms of the liver

This article details the diagnosis and imaging of primary and secondary neoplasms of the liver. Benign conditions that can mimic malignancy are also discussed, such as focal nodular hyperplasia and adenoma. Considerable attention is given to hepatoma, which is the most common primary hepatic tumor in the United States. The roles of magnetic resonance imaging, computed tomography, and ultrasound are evaluated, with recommendations for their effective use. Pitfalls in imaging related to posttreatment changes and unusual patterns of metastatic disease are illustrated.

Hepatic angiosarcoma: findings on multiphasic contrast-enhanced helical CT do not mimic hepatic hemangioma

OBJECTIVE

The objective of our study was to identify multiphasic contrast-enhanced helical CT findings of angiosarcoma of the liver to determine whether this tumor could be confused with hemangioma of the liver.

CONCLUSION

Angiosarcoma of the liver is a multifocal tumor with a variety of findings on multiphasic contrast-enhanced helical CT. None of the findings would usually be confused with the typical findings of hepatic hemangioma.