[Hemangiosarcoma of the liver. The diagnostic difficulties and therapeutic possibilities]

A 65-year-old man complained of decreasing physical capacity and weakness over the preceding six months, associated with marked painless jaundice and subsequently ascites. Despite extensive tests, some invasive, in three different hospitals no cause was found of the patient's symptoms and the marked though nonspecific abnormalities of various biochemical values (raised bilirubin concentration; increased alkaline phosphatase activity). Liver transplantation was performed because of progressive liver failure, without a firm diagnosis being established. At operation the liver was found to contain a haemangiosarcoma. The patient died 14 months after the transplantation of a suppurative cholangitis. At autopsy neither metastases nor recurrences were found.