Hepatic Angiosarcoma Masquerading as Hemangioma: A Challenging Differential Diagnosis
Hemangiomas are usually diagnosed based on ultrasound findings. The presence of symptoms, rapid growth or atipical imagiological findings should make us consider other diagnoses, including malignant tumors such as angiosarcomas. We describe the case of a previously healthy 46-year-old female without...
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| Format: | Article |
| Language: | English |
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Ordem dos Médicos
2017-10-01
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| Series: | Acta Médica Portuguesa |
| Subjects: | |
| Online Access: | http://actamedicaportuguesa.com/revista/index.php/amp/article/view/8593 |
| _version_ | 1818313362702860288 |
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| author | Ana Rita Garcia João Ribeiro Helena Gervásio Francisco Castro e Sousa |
| author_facet | Ana Rita Garcia João Ribeiro Helena Gervásio Francisco Castro e Sousa |
| author_sort | Ana Rita Garcia |
| collection | DOAJ |
| description | Hemangiomas are usually diagnosed based on ultrasound findings. The presence of symptoms, rapid growth or atipical imagiological findings should make us consider other diagnoses, including malignant tumors such as angiosarcomas. We describe the case of a previously healthy 46-year-old female without a history of exposure to carcinogens who presented with abdominal pain for two months. Diagnostic work-up revealed elevated gamma-glutamyl transferase and lactate dehydrogenase levels. Abdominal ultrasound described a large nodular lesion in the right lobe of the liver described as a hemangioma. One month later, a computed tomography-scan was made and revealed the same lesion, which had grown from 13.5 to 20 cm, maintaining typical imaging characteristics of a hemangioma. A right hepatectomy was performed and pathology revealed an angiosarcoma. After surgery, a positron emission tomography-computed tomography scan showed hepatic and bone metastasis. The patient started taxane-based chemotherapy and lumbar palliative radiotherapy, but died 10 months after surgery. This case shows how difficult it is to diagnose hepatic angiosarcoma relying only on imaging findings. Two abdominal computed tomography -scans were performed and none suggested this diagnosis. Angiosarcoma is a very aggressive tumour with an adverse prognosis. Surgery is the only curative treatment available. However, it is rarely feasible due to unresectable disease or distant metastasis. |
| first_indexed | 2024-12-13T08:32:33Z |
| format | Article |
| id | doaj.art-7d507e70e07140bb968e1e27462b8953 |
| institution | Directory Open Access Journal |
| issn | 0870-399X 1646-0758 |
| language | English |
| last_indexed | 2024-12-13T08:32:33Z |
| publishDate | 2017-10-01 |
| publisher | Ordem dos Médicos |
| record_format | Article |
| series | Acta Médica Portuguesa |
| spelling | doaj.art-7d507e70e07140bb968e1e27462b89532022-12-21T23:53:44ZengOrdem dos MédicosActa Médica Portuguesa0870-399X1646-07582017-10-01301075075310.20344/amp.85934568Hepatic Angiosarcoma Masquerading as Hemangioma: A Challenging Differential DiagnosisAna Rita Garcia0João Ribeiro1Helena Gervásio2Francisco Castro e Sousa3Serviço de Oncologia Médica. Instituto Português de Oncologia de Coimbra. Coimbra. Portugal.Serviço de Oncologia Médica. Instituto Português de Oncologia de Coimbra. Coimbra. Portugal.Serviço de Oncologia Médica. Instituto Português de Oncologia de Coimbra. Coimbra. Portugal.Serviço de Cirurgia A. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal. Departamento de Cirurgia. Faculdade de Medicina. Universidade de Coimbra. Coimbra. Portugal.Hemangiomas are usually diagnosed based on ultrasound findings. The presence of symptoms, rapid growth or atipical imagiological findings should make us consider other diagnoses, including malignant tumors such as angiosarcomas. We describe the case of a previously healthy 46-year-old female without a history of exposure to carcinogens who presented with abdominal pain for two months. Diagnostic work-up revealed elevated gamma-glutamyl transferase and lactate dehydrogenase levels. Abdominal ultrasound described a large nodular lesion in the right lobe of the liver described as a hemangioma. One month later, a computed tomography-scan was made and revealed the same lesion, which had grown from 13.5 to 20 cm, maintaining typical imaging characteristics of a hemangioma. A right hepatectomy was performed and pathology revealed an angiosarcoma. After surgery, a positron emission tomography-computed tomography scan showed hepatic and bone metastasis. The patient started taxane-based chemotherapy and lumbar palliative radiotherapy, but died 10 months after surgery. This case shows how difficult it is to diagnose hepatic angiosarcoma relying only on imaging findings. Two abdominal computed tomography -scans were performed and none suggested this diagnosis. Angiosarcoma is a very aggressive tumour with an adverse prognosis. Surgery is the only curative treatment available. However, it is rarely feasible due to unresectable disease or distant metastasis.http://actamedicaportuguesa.com/revista/index.php/amp/article/view/8593Hemangioma, Cavernous/diagnosisHemangiosarcoma/diagnosisLiver Neoplasms/diagnosis |
| spellingShingle | Ana Rita Garcia João Ribeiro Helena Gervásio Francisco Castro e Sousa Hepatic Angiosarcoma Masquerading as Hemangioma: A Challenging Differential Diagnosis Acta Médica Portuguesa Hemangioma, Cavernous/diagnosis Hemangiosarcoma/diagnosis Liver Neoplasms/diagnosis |
| title | Hepatic Angiosarcoma Masquerading as Hemangioma: A Challenging Differential Diagnosis |
| title_full | Hepatic Angiosarcoma Masquerading as Hemangioma: A Challenging Differential Diagnosis |
| title_fullStr | Hepatic Angiosarcoma Masquerading as Hemangioma: A Challenging Differential Diagnosis |
| title_full_unstemmed | Hepatic Angiosarcoma Masquerading as Hemangioma: A Challenging Differential Diagnosis |
| title_short | Hepatic Angiosarcoma Masquerading as Hemangioma: A Challenging Differential Diagnosis |
| title_sort | hepatic angiosarcoma masquerading as hemangioma a challenging differential diagnosis |
| topic | Hemangioma, Cavernous/diagnosis Hemangiosarcoma/diagnosis Liver Neoplasms/diagnosis |
| url | http://actamedicaportuguesa.com/revista/index.php/amp/article/view/8593 |
| work_keys_str_mv | AT anaritagarcia hepaticangiosarcomamasqueradingashemangiomaachallengingdifferentialdiagnosis AT joaoribeiro hepaticangiosarcomamasqueradingashemangiomaachallengingdifferentialdiagnosis AT helenagervasio hepaticangiosarcomamasqueradingashemangiomaachallengingdifferentialdiagnosis AT franciscocastroesousa hepaticangiosarcomamasqueradingashemangiomaachallengingdifferentialdiagnosis |