3.Analysis of clinicopathological features of 18 cases of hepatic angiosarcoma.
Ying Ying ZHOU ; Han WANG ; Zhi Hong XIAN ; Wen Ming CONG ; Hui DONG
Chinese Journal of Hepatology 2023;31(7):729-735
Objective: To investigate the clinicopathological features, treatment, and prognosis of hepatic angiosarcoma. Methods: Clinicopathological data and prognostic conditions of 18 cases with hepatic angiosarcoma were collected retrospectively. The recurrence-free survival rate and overall survival rate were calculated by the Kaplan-Meier method. A Cox regression analysis was used to explore the survival-related risk factors. Results: There were 12 male and 6 female patients, with an average age of 57 (37 ~ 70) years. The tumor's average diameter was 8.40 (2.00 ~ 18.00) cm. Seven cases had multiple tumors, while two cases had large vessel tumor thrombuses. Microscopically, the tumor tissues were irregularly anastomosed, with vascular lacunar or solid bundle-like weaving, and the tissue morphology mimicked capillary hemangioma, cavernous hemangioma, or angioepithelioma, while tumor cells were spindle-shaped or epithelioid, lined with hobnails in the lumen, or formed papillary structures in the lumen. The proportion of highly, moderately, and poorly differentiated tumors was 4:8:6, with six cases having clear tumor boundaries, eight having microvascular tumor thrombi, and sixteen having blood lake formation. Different levels of expression of CD31, CD34, erythroblast transformation-specific related genes, and Fli-1 markers were demonstrated in all of the cases. Four cases had a P53 mutation, and six cases had Ki-67 > 10%. During the follow-up period of 0.23-114.20 months, the five-year recurrence-free survival rate and overall survival rate were 16.7% and 37.2%, respectively. Cox regression multivariate analysis showed that preoperative symptoms and multiple tumors were significant risk factors for recurrence-free survival, while preoperative symptoms and Ki-67 > 10% were significant risk factors for overall survival. Conclusion: Hepatic angiosarcoma is a rare hepatic mesenchymal tumor with high malignancy and a poor prognosis. Pathological morphology and immunohistochemical marker combinations are needed for a definite diagnosis. However, the complexity of angiosarcomas' histological and cytological conformations and the overlap of pathological features with benign vascular tumors, sarcomas, and carcinomas pose difficulties in the differential diagnosis. Thus, the only effective ways to prolong survival are early detection and radical surgical resection.
Humans
;
Male
;
Female
;
Middle Aged
;
Hemangiosarcoma
;
Ki-67 Antigen
;
Retrospective Studies
;
Biomarkers, Tumor/metabolism*
;
Prognosis
;
Liver Neoplasms/pathology*
4.Primary hepatic angiosarcoma: a clinicopathological analysis of nine cases.
S ZHAO ; Y ZHU ; S Y MA ; Q H FAN ; Q X GONG
Chinese Journal of Pathology 2023;52(11):1132-1137
Objective: To investigate the clinical manifestations, histomorphology, and differential diagnosis of primary hepatic angiosarcoma. Methods: Nine cases of primary hepatic angiosarcoma diagnosed in the Department of Pathology, the First Affiliated Hospital of Nanjing Medical University from January 2014 to December 2021 were collected, including biopsy and surgical specimens. The histomorphology, clinical, and radiologic findings were analyzed. The relevant literature was also reviewed. Results: There were six males and three females, aged 30 to 73 years (mean 57 years). Grossly, the growth pattern of the tumor was classified as either mass formation or non-mass formation (sinusoidal). Microscopically, the mass-forming primary hepatic angiosarcoma were further subdivided into vasoformative or non-vasoformative growth patterns; and those non-vasoformative tumors had either epithelioid, spindled, or undifferentiated sarcomatoid features. Sinusoidal primary hepatic angiosarcoma on the other hand presented with markedly dilated and congested blood vessels of varying sizes, with mild to moderately atypical endothelial cells. Follow-up in all nine cases revealed 8 mortality ranging from 1 to 18 months (mean 5 months) from initial diagnosis. One patient was alive with disease within a period of 48 months. Conclusions: Primary hepatic angiosarcoma is a rare entity with a wide spectrum of histomorphology, and often misdiagnosed. It should be considered when there are dilated and congested sinusoids, with overt nuclear atypia. The overall biological behavior is aggressive, and the prognosis is worse.
Male
;
Female
;
Humans
;
Hemangiosarcoma/diagnosis*
;
Endothelial Cells/pathology*
;
Liver Neoplasms/surgery*
;
Prognosis
;
Biopsy
5.Angiosarcoma around Hip Joint Prosthesis.
Wei ZHU ; Bin FENG ; Qi MA ; Yu-Long LI ; Xi-Tao SONG ; Xi-Sheng WENG
Chinese Medical Journal 2016;129(21):2642-2643
6.Primary Pulmonary Low-Grade Angiosarcoma Characterized by Mismatch between 18F-FDG PET and Dynamic Contrast-Enhanced CT.
Eun Young KIM ; Ho Yun LEE ; Joungho HAN ; Joon Young CHOI
Korean Journal of Radiology 2015;16(5):1166-1170
We report a rare case of primary pulmonary low-grade angiosarcoma on dynamic contrast-enhanced CT and 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT imaging. A 38-year-old, asymptomatic woman was hospitalized because of an abnormality on chest radiography. A dynamic contrast-enhanced chest CT showed a 1.2 cm-sized irregular-margined nodule with strong and persistent enhancement in the right lower lobe. The lesion had low metabolic activity on an 18F-FDG PET/CT scan. The patient underwent a wedge resection for the lesion, and pathology revealed a primary pulmonary low-grade angiosarcoma.
Adult
;
Female
;
Fluorodeoxyglucose F18/*chemistry
;
Hemangiosarcoma/*diagnosis/pathology/radiography
;
Humans
;
Ki-67 Antigen/metabolism
;
Lung Neoplasms/*diagnosis/pathology/radiography
;
Multimodal Imaging
;
*Positron-Emission Tomography
;
Radiopharmaceuticals/*chemistry
;
Tomography, Spiral Computed
7.Clinical Courses of Primary Hepatic Angiosarcoma: Retrospective Analysis of Eight Cases.
Chang Jae HUR ; Bo Ram MIN ; Yoo Jin LEE ; Byung Kuk JANG ; Jae Seok HWANG ; Eun Soo KIM ; Kyung Sik PARK ; Kwang Bum CHO ; Yu Na KANG ; Woo Jin CHUNG
The Korean Journal of Gastroenterology 2015;65(4):229-235
BACKGROUND/AIMS: Hepatic angiosarcoma, a rare and aggressive liver malignancy, is difficult to diagnose because of a lack of specific clinical features. The clinical and radiological features of patients with histologically confirmed hepatic angiosarcoma were examined. METHODS: Among 2,336 patients diagnosed with primary hepatic carcinoma at Keimyung University Dongsan Medical Center (Daegu, Korea) between May 2002 and February 2012, eight (0.03%) with histologically confirmed primary hepatic angiosarcoma were included. The patterns of disease diagnosis, tumor characteristics, treatment responses, and prognoses were reviewed retrospectively. RESULTS: Median age was 66 years-old (range, 41-80 years). Four patients were male. Five patients were compulsive drinkers. All patients had no HBsAg and anti-HCV. Initial radiologic diagnoses revealed primary hepatic angiosarcoma (n=2), hepatocellular carcinoma (n=2), hemangioma (n=2), and hepatic metastatic carcinoma (n=2). Definitive diagnoses were made by percutaneous needle biopsies in seven patients and surgical resection in one patient. At the time of the initial diagnosis, extrahepatic metastases were detected in three patients (37.5%). Metastatic sites included the spleen and lung, pericardium, and bone, in one patient each. Two patients underwent conservative treatments. The remaining patients underwent surgical resection (n=1), transcatheter arterial chemoembolization (n=1), and systemic chemotherapy (n=4). The median survival period was 214 days (range, 21-431 days). CONCLUSIONS: Hepatic angiosarcoma is a highly progressive disease with a poor prognosis. Detailed studies including histological examinations are essential to facilitate early diagnosis of the disease.
Adult
;
Aged
;
Aged, 80 and over
;
Antineoplastic Agents/therapeutic use
;
Embolization, Therapeutic
;
Female
;
Hemangiosarcoma/*diagnosis/pathology/therapy
;
Humans
;
Immunohistochemistry
;
Liver Neoplasms/*diagnosis/pathology/therapy
;
Male
;
Middle Aged
;
Neoplasm Metastasis
;
Prognosis
;
Retrospective Studies
;
Survival Rate
;
Tomography, X-Ray Computed
8.Anastomosing hemangioma: a case report.
Jianguo YAO ; Hongjia PAN ; Chunhua WANG ; Feng XIAO ; Qinhe FAN ; Weihao JIANG ; Jianqiu XU
Chinese Journal of Pathology 2015;44(2):133-134
9.Diagnostic experience in 3 cases of cardiac occupying lesion.
Yangzhao ZHOU ; Zhaoshun YUAN ; Xiaobo LIAO ; Xinmin ZHOU
Journal of Central South University(Medical Sciences) 2015;40(11):1281-1284
The clinic symptoms of cardiac occupying lesions are complex and difficult to diagnose currently. In this study, three cases of atrial angiosarcoma, left ventricular aneurysm and left ventricular diverticulum were selected, respectively. The clinical characteristics, imaging features (echocardiogram, cardiac CT and MRI) and the postoperative and pathological results for patients were studied. We compared the differences in clinical symptoms, morphology, histology and haemodynamics among the three patients. The diagnosis were confirmed by intraoperative and postoperative pathological examination. We conclude that proper imaging approaches would be beneficial to diagnose the cardiac occupying lesions. Accurate preoperative diagnosis is beneficial to preoperative preparation as well as the decrease in operative risks.
Diverticulum
;
diagnosis
;
Echocardiography
;
Heart Aneurysm
;
diagnosis
;
Heart Ventricles
;
pathology
;
Hemangiosarcoma
;
diagnosis
;
Humans
;
Magnetic Resonance Imaging
;
Tomography, X-Ray Computed
10.Feasibility analysis of endostatin combined with chemotherapy in the treatment of metastatic angiosarcoma.
Yongxia CUI ; Zhifen LUO ; Chuangxin LU ; Bing BAI
Chinese Journal of Oncology 2014;36(5):387-388
Adult
;
Aged
;
Antineoplastic Agents
;
therapeutic use
;
Antineoplastic Combined Chemotherapy Protocols
;
therapeutic use
;
Bone Neoplasms
;
drug therapy
;
secondary
;
Endostatins
;
therapeutic use
;
Epirubicin
;
administration & dosage
;
Feasibility Studies
;
Female
;
Follow-Up Studies
;
Hemangiosarcoma
;
drug therapy
;
pathology
;
Humans
;
Liver Neoplasms
;
drug therapy
;
secondary
;
Male
;
Middle Aged
;
Pubic Bone
;
pathology
;
Taxoids
;
administration & dosage

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