Primary epithelioid angiosarcoma of the liver

A 67-year-old woman presented with abdominal pain and fever and was found to have multiple liver masses, up to 6 cm in size, that had not been detected on ultrasound 2 months earlier. The rapid onset of lesions, elevated inflammatory markers, and mildly increased liver enzymes initially suggested liver abscesses based on radiographic findings. However, the patient showed no response to antimicrobial therapy, and contrast-enhanced ultrasonography indicated a primary liver tumor. Biopsy revealed a poorly differentiated carcinoma or sarcoma, and the patient died 11 days after admission. Autopsy, combined with immunohistopathological analysis, confirmed primary hepatic epithelioid angiosarcoma (EAS). We presented a rare case of hepatic EAS, highlighting its clinical course, radiological features, and pathological findings.