Hepatic angiosarcoma: A challenging diagnosis

Primary hepatic angiosarcoma (PHA) is a rare and aggressive malignancy, accounting for roughly 2% of primary hepatic cancers. It is characterized by rapid progression and nonspecific clinical symptoms, making early diagnosis challenging. This case report describes a 59-year-old male who initially presented with right upper quadrant (RUQ) pain, dizziness, and presyncope, with initial imaging findings suggesting hemoperitoneum secondary to hepatic arteriovenous malformations (AVM). A comprehensive diagnostic approach, including computed tomography (CT) angiography, magnetic resonance imaging (MRI), and surgical biopsy, ultimately confirmed PHA. This case underscores the difficulty in diagnosing PHA due to its varied imaging presentations and highlights the need for improved diagnostic strategies and early detection.