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Hepatic Angiosarcoma : Treatment & Prognosis

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Treatment of Hepatic Angiosarcoma (HAS): HAS is a highly aggressive tumor. Death occurs within months of diagnosis (median survival is 6 months), mostly due to hepatic failure or hemoperitoneum (from tumor rupture). Less than 5% of patients survive for more than 2 years after diagnosis. The most frequently involved metastatic sites are lung, spleen, and bone.

Surgical resection (partial hepatectomy) is the only treatment option that offers possible cure. When combined with adjuvant chemotherapy, the median survival is about 17 months. Radiation therapy offers no benefit. Liver transplantation is not an option due to high recurrence rates and poor survival post-transplant.

Chemotherapy regimens consisting of 5-FU, carboplatin, doxorubicin, and ifosfamide have been found useful. Metastatic tumors are treated with salvage chemotherapy consisting of taxanes which have anti-angiogenic properties.

This image shows endothelial cells with minimal cytologic atypia lining dilated preexisting sinusoids. There is hepatocyte atrophy and mild fibrosis. This was a case of well-differentiated primary hepatic angiosarcoma in a patient with history of thorotrast administration for cerebral arteriography.

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