[Hepatic angiosarcomas]

The authors describe three cases of hepatic angiosarcoma diagnosed at postmortem examination, two of them being associated to thorium dioxide. The low incidence of these tumors amongst the general population is commented upon, and an update is made on the factors involved in their appearance, with special mention of thorium dioxide. An analysis of the clinical picture of the disease is undertaken, emphasizing its diagnostic difficulties. A tentative diagnosis can be made on the basis of clear-cut epidemiological data and or the presence of increased radiological density over the liver, spleen and paraaortic lymph nodes in the cases associated to thorium dioxide. Two of the reported patients presented hemolytic anemia, and disseminated intravascular coagulation, respectively; these findings, although nonspecific, may suggest the diagnosis in the presence of a toxic clinical picture or one of the above mentioned factors. The diagnosis should be made by the usual techniques utilized clinically to detect space occupying lesions within the liver. The evolution of such patients is rapidly progressive, with a fatal outcome within three to six months after beginning of symptoms.