Silent Killer in the Liver: A Rare Case of Primary Hepatic Angiosarcoma Presenting With Acute Liver Failure

Primary hepatic angiosarcoma (PHA) is a rare malignant tumor of the liver with an extremely poor prognosis even after diagnosis and treatment. It is difficult to diagnose due to a lack of disease-specific clinical features, tumor markers, or imaging findings. Due to its rarity of occurrence, treatment protocols are not yet clear. We present a rare case of PHA in a 39-year-old female who presented with right upper quadrant abdominal pain and was found to have acute liver failure and a non-resectable liver mass. She underwent a liver transplant (LT) as PHA could not be diagnosed before the transplant. She received chemotherapy and had done well for 12 months until her carcinoma relapsed. She underwent a repeat cycle of chemotherapy; however, her tumor continued to progress and is now undergoing a trial of immunotherapy.