Clinical Characteristics Of Primary Hepatic Angiosarcoma

Background Primary hepatic hemangiosarcoma,also known as intrahepatic malignant hemangioma,is a rare and difficult-to-diagnose hepatic malignant tumor originating from sinusoidal endothelial cells,accounting for 0.1%-2% of primary hepatic malignant tumors.Most patients die within one year after diagnosis.The etiology of the disease is not clear at present.Some scholars believe that it is related to cyanoethylene poisoning and arsenic poisoning.Researchers have found that patients have a history of using thorium dioxide preparations,and the relationship between thorium dioxide and cirrhosis is unknown.Hepatic manifestations of primary hepatic hemangiosarcoma may be diffuse micro-nodular,diffuse multi-nodular,giant,mixed and other different types.However,due to many factors,such as difficult to find clinical symptoms,lack of typical imaging examinations,and easy neglect of patients themselves,it is difficult to make a definite diagnosis,resulting in poor prognosis.This paper reports five cases of hepatic angiosarcoma and makes a comprehensive analysis of the literature.Objective To find out the relative clinical and imaging rules of hepatic angiosarcoma in order to improve the understanding of hepatic angiosarcoma.Methods The clinical data,imaging data and manifestations of 5 patients with primary hepatic sarcoma admitted to our hospital from 2005 to 2018 were retrospectively analyzed.The etiology,clinical manifestations and imaging features of 20 patients with primary hepatic sarcoma from 2009 to 2019 were analyzed comprehensively.In order to find out the relative rules of clinical and imaging,the diagnosis,differential diagnosis,treatment and prognostic factors of the disease were discussed.SPSS6.0 statistical software was used for data analysis.Results The average age of primary hepatic angiosarcoma patients was 60 years old.The proportion of male patients increased significantly,and 75% of them were over 50 years old.The first clinical symptoms were abdominal pain(65%),followed by abdominal distension(35%).On the whole,the pathological features were massive and multiple nodules,and hemorrhage could be seen in some cases.Microscopically,the tumor cells are spindle,irregular,round and quasi-circular,showing giant cell tumors;the edge of the tumor cells is not clear,the nucleus is deep-stained,the cytoplasm is rich,and pathological mitosis can be seen.Immunohistochemistry: The positive rates of CD31,CD34 and F were 60%,60% and 8%.At present,the follow-up period is between 1 day and 14 months.At present,10% of the patients survive during the follow-up period,and the median survival time of the dead patients is 3 months.The prognostic factors include the general general general condition and metastasis of the patients.It should be pointed out that in the literature,1 case of missing follow-up and 6cases of irregular follow-up occurred during the follow-up of some patients.Conclusion Primary hepatic angiosarcoma is a rare and difficult malignant tumor with poor prognosis.Its clinical manifestations are mostly nonspecific.The diagnosis depends on the pathology and immunohistochemistry of liver biopsy.Surgical excision is the first choice for patients with localized growth of mass without rupture and bleeding,multiple intrahepatic and extrahepatic metastases,and early diagnosis,but the long-term prognosis is still poor.