Atezolizumab and Bevacizumab prior to liver transplantation in hepatic angiosarcoma mimicking hepatocellular carcinoma

Hepatic angiosarcoma is a rare yet aggressive malignancy, which is prone to misdiagnosis due to the lack of specific molecular and radiological characteristics. The treatment regimens remain controversial and disappointing. Randomized clinical trials are limited due to the rarity of this specific aggressive malignancy. Independent case reports or series can provide relevant references for treatment. We reported the very first hepatic angiosarcoma received Atezolizumab and Bevacizumab as a first-line treatment prior to liver transplantation, which resulted in a partial pathological response under specific molecular mutations. This case illustrates the potential role of immune checkpoint inhibitor combined with anti-angiogenic therapy as an off-label treatment option warranting further investigation.