Hepatic angiosarcoma with multiple metastases in a young man.

Area of Science:

• Oncology
• Hepatology
• Pathology

Background:

• Hepatic angiosarcoma (HAS) is a rare, aggressive primary liver malignancy originating from endothelial cells, accounting for <2% of all primary liver neoplasms.
• This neoplasm is challenging to diagnose due to its infrequent occurrence and often asymptomatic presentation, leading to incidental discovery.
• Rapid progression and a typically fatal outcome necessitate early diagnosis and intervention.

Observation:

• This report details a rare case of advanced hepatic angiosarcoma with widespread infiltration.
• Imaging revealed multifocal liver and spleen nodules with high vascularity, alongside extensive metastases in the lungs, right atrium, and spine.
• The patient's condition rapidly declined within two months post-imaging.

Findings:

• Contrast-enhanced CT and MRI confirmed extensive metastatic disease in multiple organs.
• Open biopsy ultimately confirmed the diagnosis of hepatic angiosarcoma.
• The advanced stage at diagnosis precluded surgical resection.

Implications:

• This case underscores the aggressive nature of hepatic angiosarcoma and the diagnostic challenges it presents.
• Widespread dissemination at presentation highlights the critical need for improved early diagnostic modalities.
• Complete surgical resection, the primary curative option, is often not feasible due to late-stage diagnosis.