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
ARTICLE HIGHLIGHTS
Case characteristics

A 72-year-old man visited our institution due to the onset of abdominal pain.

Clinical diagnosis

Computed tomography (CT) and magnetic resonance (MR) images revealed a liver tumor.

Differential diagnosis

Hepatocellular carcinoma and another type of malignant tumor of the liver.

Laboratory diagnosis

Laboratory tests demonstrated liver enzyme elevation. Alpha-fetoprotein, des-gamma-carboxy prothrombin, carcinoembryonic antigen and carbohydrate antigen were within normal range.

Imaging diagnosis

Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced (Gd-EOB-DTPA -enhanced) MR imaging revealed a liver tumor that showed slight hyperintensity in the hepatobiliary phase.

Pathological diagnosis

Atypical endothelial cells had regularly infiltrated into the sinusoid and replaced sinusoidal cells in a broad range of hepatic parenchyma; as a result, hepatic cell cords remained in the tumor. Pathological findings were consistent with hepatic angiosarcoma.

Treatment

After admission, the patient experienced worsening liver and renal failure. He died from multiple organ failure nine days after admission.

Related reports

Hepatic angiosarcoma has various appearances on CT and MR images, but contrast uptake in primary hepatic angiosarcoma on Gd-EOB-DTPA-enhanced MR imaging in the hepatobiliary phase has not been reported.

Term explanation

There are no non-standard terms used in this manuscript.

Experiences and lessons

The authors present this case to share important knowledge for hepatic angiosarcoma diagnosis.