Published online Jan 27, 2018. doi: 10.4254/wjh.v10.i1.166
Peer-review started: September 15, 2017
First decision: October 31, 2017
Revised: November 6, 2017
Accepted: December 28, 2017
Article in press: December 28, 2017
Published online: January 27, 2018
Primary hepatic angiosarcoma is the most common malignant mesenchymal tumor of the liver. It has a poor prognosis and various appearances on magnetic resonance (MR) images. We report a case of hepatic angiosarcoma with a characteristic appearance on gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced MR imaging in the hepatobiliary phase. A 72-year-old man was admitted with a complaint of abdominal pain. Gd-EOB-DTPA-enhanced MR imaging revealed a liver tumor that showed slight hyperintensity in the hepatobiliary phase. These findings suggested Gd-EOB-DTPA uptake in the tumor. An autopsy revealed the solid proliferation and sinusoidal spreading of hepatic angiosarcoma cells. Immunohistochemistry indicated that the tumor was negative for OATP1B3. Gd-EOB-DTPA uptake in the liver tumor in the hepatobiliary phase suggested sinusoidal tumor invasion with residual normal hepatocytes.
Core tip: Hepatic angiosarcoma has various appearances on computed tomography and magnetic resonance (MR) images. In the context of cirrhosis, hepatic angiosarcoma often cannot be readily distinguished from hepatocellular carcinoma. We present contrast uptake in primary hepatic angiosarcoma on gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced MR imaging in the hepatobiliary phase, and contrast uptake suggested sinusoidal tumor invasion with residual normal hepatocytes. This finding may assist physicians in the diagnosis of future cases of hepatic angiosarcoma.