Hepatic hemangiosarcoma: imaging findings and differential diagnosis

Primary hepatic angiosarcoma is a rare mesenchymal tumor of the liver that usually presents with nonspecific symptoms in elderly men. We present four cases of hepatic hemangiosarcoma and discuss the imaging characteristics of this entity. Our series shows that this tumor is not uncommon in younger patients with no associated risk factors such as previous exposure to thorotrast or vinyl chloride. Our experiences on a limited number of patients suggests that the combined use of angiography and dual-phase helical CT provides a better identification of the tumor and its complications. Analysis of imaging studies in patients with hepatic hemangiosarcoma reveals hypervascular lesions. Common complications were portal vein thrombosis, Budd-Chiari syndrome, as well as arterio-venous or arterio-portal shunts. Due to the vascularity of the tumor, percutaneous liver biopsy is hazardous. Received: 20 November 1998; Revised: 2 March 1999; Accepted: 12 April 1999     

成人肝错构瘤恶变血管肉瘤1例

1．临床资料:患者女性,33岁,因右上腹胀痛,发现肝脏多发占位8年,出现腹水半年入院。患者无肝炎后肝硬化病史。8年前因右上腹胀痛查CT示多发占位,行肝穿刺活检为肝     

Hemangiosarcoma and hepatocellular carcinoma of the liver following vinyl chloride exposure

Summary A report is given of the clinical and autopsy findings of two men who died from malignant liver neoplasm following occupational exposure to vinyl chloride. The first patient was a 44-year-old man with an hemangiosarcoma of the liver, the second patient a 67-year-old man with an hepatocellular carcinoma. So far an hepatocellular carcinoma due to vinyl chloride has not yet been observed in man. Its occurrence, however, has been suggested from the results of animal experiments. The connection of hepatocellular carcinoma with exposure to vinyl chloride is discussed.

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Zusammenfassung Es wird über zwei bösartige Lebererkrankungen nach beruflicher Exposition von Vinylchlorid berichtet. Dabei handelt es sich um ein typisches Haemangiosarkom bei einem 44 Jahre und ein hepatocelluläres Carcinom bei einem 67 Jahre alt gewordenen Chemiearbeiter. Bis jetzt ist ein hepatocelluläres Carcinom nach gesicherter Vinylchloridexposition beim Menschen nicht beobachtet worden. Hepatocelluläre Carcinome nach Vinylchloridexposition waren jedoch aus tierexperimentellen Untersuchungen bekannt und ihr Vorkommen auch beim Menschen vermutet worden.

     

右侧颈部巨大上皮样血管肉瘤1例

患者女,32岁,发现右颈部包块3个月,约2 cm× 1.5 cm大小,表面光滑,质硬,无压痛,无波动,活动度小,不随吞咽上下移动.近期感头痛、胸闷、咳嗽、颈部包块逐渐长大.B超:右侧颈部实质性肿块伴周围淋巴结肿大,右侧颈动脉受压弯曲.     

Piperonyl butoxide induces hepatocellular carcinoma in male CD-1 mice

Male CD-1 mice in groups of 52, 53 or 100 were administered piperonyl butoxide (α-[2-(2-butoxyethoxy)ethoxy-4,5-methylenedioxy-2-propyltoluene) in the diet at levels of 0 (control), 0.6 and 1.2% for 12 months. Hepatocellular carcinoma was induced in treated groups in a dose-dependent manner but not in the control group. The incidences of hepatocellular carcinoma were 11.3 and 52.0% in mice given 0.6 and 1.2% piperonyl butoxide, indicating that piperonyl butoxide can cause hepatocellular carcinoma in mice as it is known to do in rats. Received: 18 January 1994/Accepted: 8 March 1994     

Enormous hemangiosarcoma of the heart

This report describes a 26-year-old patient with hemangiosarcoma of the heart and summarizes the clinicopathological features in previous reports of patients with cardiac angiosarcoma. The patient was admitted to our hospital because of a syncope and one episode of nocturnal dyspnea and hemoptysis. In his history he complained of progressive weakness and loss of weight over the past 2 months. Echocardiography and computed tomography of the chest showed inhomogeneous masses in the pericardial cavity completely surrounding the heart and involving the ascending aorta and the superior vena cava. Histological examination of the tissue obtained from the mass by fine needle technique revealed a poorly differentiated malignant tumor of mesenchymal origin. Exploratory thoracotomy followed by tumor biopsies showed an inoperable cardiac hemangiosarcoma of enormous size with multiple metastases in both lungs. Palliative tumor resection was not performed. During the postoperative course the patient still required controlled ventilation. After 3 days of cytostatic chemotherapy no regression of tumor mass was seen by chest radiography. Cardiorespiratory insufficiency was progressive, and the patient died within 3 weeks after admission.     

Primary Splenic Angiosarcoma

Primary splenic angiosarcoma is a rare, aggressive malignant neoplasm arising from splenic vascular endothelium. A 70-year-old woman presented with shortness of breath and chest discomfort secondary to a left-sided pleural effusion. A thoracentesis revealed a reactive effusion suspicious for malignancy. Splenic enlargement with heterogeneous enhancement was identified on CT of the abdomen. Laboratory findings at initial presentation revealed mild anemia (10.5g/dL) with normal platelets (300 × 10⁹/L). Laparoscopic splenectomy was performed, and a primary splenic angiosarcoma was discovered. After 2 rounds of chemotherapy, a CT scan showed progressive disease with metastasis to the liver and lung. The patient''s antineoplastic regimen was switched to Ifosfamide and Doxorubicin. She is currently alive with evidence of disease at 9 months but without further progression. Primary splenic angiosarcoma is almost universally fatal despite treatment. The best chance for survival is early diagnosis and prompt splenectomy prior to splenic rupture.     

磷酸化Stat3和磷酸化Akt及细胞周期蛋白D1在血管肉瘤中的表达

目的 探讨磷酸化细胞信号传导与转录活化因子3(Stat3)和磷酸化Akt及细胞周期蛋白D1在血管肉瘤中的表达.方法 采用免疫组化ABC的方法检测磷酸化Stat3(p-Stat3)和磷酸化Akt(pAkt)及细胞周期蛋白D1在21例血管肉瘤和15例毛细血管瘤石蜡包埋切片中的表达.结果 在21例血管肉瘤石蜡包埋切片中,有15例p-Stat3表达阳性,11例p-Akt表达阳性,16例细胞周期蛋白D1表达阳性;而在15例毛细血管瘤中仅有4例p-Stat3表达阳性,2例p-Akt表达阳性,4例细胞周期蛋白D1表达阳性,两组各阳性表达率分别经卡方检验发现,差异均有统计学意义(P<0.05).在血管肉瘤中,p-Stat3阳性表达与细胞周期蛋白D1的阳性表达有相关性(r=0.62,P=0.003),而p-Akt阳性表达与细胞周期蛋白D1的阳性表达无相关性(r=-0.09,P=0.700).结论 p-Stat3、p-Akt和细胞周期蛋白D1在血管肉瘤的形成机制中可能起一定的作用.