Published online May 15, 2022. doi: 10.4251/wjgo.v14.i5.1050
Peer-review started: November 27, 2021
First decision: January 8, 2022
Revised: January 20, 2022
Accepted: April 20, 2022
Article in press: April 20, 2022
Published online: May 15, 2022
Processing time: 163 Days and 19.5 Hours
Primary hepatic angiosarcoma (PHA) is a rare malignancy with a poor prognosis. It is difficult to diagnose PHA because of the lack of specific symptoms or tumour markers, and it rapidly progresses and has a high mortality. To our knowledge, PHA has not been reported to mimic hepatic sinusoidal obstruction syndrome. Herein, we present a case of PHA manifesting as hepatic sinusoidal obstruction syndrome, diagnosed using transjugular liver biopsy, that resulted in the death of the patient.
A 71-year-old man was admitted with the primary complaint of abdominal distension, decreased appetite, fatigue in the previous month, and loss of 10 kg of weight in the past 2 years. Both the liver and spleen were enlarged, and the liver had a medium-hard texture on percussion. Laboratory examinations were performed, and abdominal plain computed tomography (CT) and contrast-enhanced CT showed hepatomegaly and splenomegaly, as well as diffuse low-density shadows distributed in the liver and spleen. Contrast-enhanced CT revealed diffuse, hypodense, nodular or flake shadows in the liver and heterogeneous enhancement in the spleen. A transjugular liver biopsy was performed. Based on the pathology results, the patient was diagnosed with hepatic sinusoidal obstruction syndrome secondary to PHA. The patient’s status further deteriorated and he developed serious hepatic failure. The patient was discharged, and died 3 d later.
PHA is rare and has a poor prognosis; however, transjugular liver biopsy can be safely performed to aid in diagnosis.
Core Tip: To our knowledge, primary hepatic angiosarcoma (PHA) has not been reported to mimic hepatic sinusoidal obstruction syndrome. Here, we present a patient who died from PHA, which manifested as hepatic sinusoidal obstruction syndrome and was diagnosed by transjugular liver biopsy.