Liver Angiosarcoma

Abstract: In 1974, vinyl chloride (VC) was first reported in the open scientific literature to induce angiosarcoma of the liver both in humans and in animals Additional research has now demonstrated the carcinogenicity of VC to other organs and at lower concentrations The target organs for VC now clearly include the liver, brain and the lung, and probably the lymphohematopoietic system The evidence for a carcinogenic risk has been extended to jobs associated with poly(vinyl chloride) exposure Cases of liver angiosarcoma have been reported among individuals employed in PVC fabrication facilities and an epidemiological study has demonstrated a significant association between exposure to PVC dust and the risk of lung cancer mortality Cases of angiosarcoma of the liver also have been reported among individuals living in near proximity to vinyl chloride-poly(vinyl chloride) plants An association between PVC dust and pneumoconiosis also has been demonstrated On the basis of findings, prudent control of PVC dust in the industrial setting is indicated

Abstract: Open or closed biopsy of liver angiosarcoma is a life-threatening procedure. A case of massive bleeding after fine needle aspiration of the liver is reported in a patient having an angiosarcoma of the liver and spleen. Fine needle aspiration seems a hazardous procedure in this disease.

Abstract: OBJECTIVES Liver hemangiomas are vascular tumors, which occur in the first months of life and carry risks of initial complications, but are considered to be benign histologically and to regress with time. Histologic studies suggest that a subtype, type 2 hemangioendothelioma, is akin to angiosarcoma and may have a severe long-term prognosis. We report 5 girls with type 2 hemangioendothelioma of the liver. METHODS AND RESULTS Three children initially presented with classical infantile multinodular hemangioma, including cardiac and pulmonary complications and regression of tumors at age 1½ to 2½ years. All 3 experienced tumor relapse at ages 2½ to 3, leading to death at ages 2½ to 5. Tumor histology showed type 2 hemangioendothelioma. The other 2 children presented with liver tumors at ages 2 and 3 years. In 1, initial biopsy of a single tumor showed benign type 1 hemangioendothelioma, but surgical resection was followed by relapse in the remaining liver, lung metastases, and death. Whole tumor histology showed both type 1 and 2 lesions. In the other child, tumor biopsy showed type 2 lesions. She underwent liver transplantation and is alive without tumor recurrence 3 years later. CONCLUSIONS Careful follow-up is necessary to detect late recurrence in infants with multinodular liver hemangiomas. Vascular liver tumors occurring after infancy are likely to be malignant. The high risk of relapse in the remaining liver suggests that if no metastases are detected, liver transplantation is preferable to surgical tumor resection in both situations.