Case Report
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Jan 27, 2018; 10(1): 166-171
Published online Jan 27, 2018. doi: 10.4254/wjh.v10.i1.166
Contrast uptake in primary hepatic angiosarcoma on gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging in the hepatobiliary phase
Manabu Hayashi, Satoshi Kawana, Hirofumi Sekino, Kazumichi Abe, Naoki Matsuoka, Masahito Kashiwagi, Ken Okai, Yukiko Kanno, Atsushi Takahashi, Hiroshi Ito, Yuko Hashimoto, Hiromasa Ohira
Manabu Hayashi, Kazumichi Abe, Naoki Matsuoka, Masahito Kashiwagi, Ken Okai, Yukiko Kanno, Atsushi Takahashi, Hiromasa Ohira, Department of Gastroenterology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
Satoshi Kawana, Yuko Hashimoto, Department of Diagnostic Pathology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
Hirofumi Sekino, Hiroshi Ito, Department of Radiology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
Author contributions: Hayashi M, Abe K and Ohira H designed the report; Hayashi M wrote the paper; Hayashi M, Matsuoka N, Kashiwagi M and Kanno Y treated the patient; Kawana S and Hashimoto Y performed an autopsy and analyzed histological findings; Sekino H and Hiroshi I made the radiological diagnosis; Okai K, Takahashi A and Ohira H critically reviewed the manuscript.
Informed consent statement: Patients had been informed and signed consent for participation in the study.
Conflict-of-interest statement: There are no conflicts of interest to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Manabu Hayashi, MD, Department of Gastroenterology, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima 960-1295, Japan. m884884@fmu.ac.jp
Telephone: +81-24-5471111 Fax: +81-24-5471991
Received: October 11, 2017
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
Abstract

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.

Keywords: Hepatic angiosarcoma, Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid, Cirrhosis, Hepatocellular carcinoma

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.