Key result
Transjugular liver biopsy successfully diagnosed primary hepatic angiosarcoma manifesting as hepatic sinusoidal obstruction syndrome in a 71-year-old man who subsequently died from severe hepatic failure.
Why the study?
Primary hepatic angiosarcoma is difficult to diagnose and had not previously been reported to mimic hepatic sinusoidal obstruction syndrome.
Case Report (n=1)
Transjugular liver biopsy can be safely performed to aid in the diagnosis of primary hepatic angiosarcoma manifesting as hepatic sinusoidal obstruction syndrome.
BACKGROUND: Primary hepatic angiosarcoma (PHA) is a rare malignancy with a poor prognosis. It is difficult to diagnose PHA because of the lack of specific symptoms or tumour markers, and it rapidly progresses and has a high mortality. To our knowledge, PHA has not been reported to mimic hepatic sinusoidal obstruction syndrome. Herein, we present a case of PHA manifesting as hepatic sinusoidal obstruction syndrome, diagnosed using transjugular liver biopsy, that resulted in the death of the patient. CASE SUMMARY: A 71-year-old man was admitted with the primary complaint of abdominal distension, decreased appetite, fatigue in the previous month, and loss of 10 kg of weight in the past 2 years. Both the liver and spleen were enlarged, and the liver had a medium-hard texture on percussion. Laboratory examinations were performed, and abdominal plain computed tomography (CT) and contrast-enhanced CT showed hepatomegaly and splenomegaly, as well as diffuse low-density shadows distributed in the liver and spleen. Contrast-enhanced CT revealed diffuse, hypodense, nodular or flake shadows in the liver and heterogeneous enhancement in the spleen. A transjugular liver biopsy was performed. Based on the pathology results, the patient was diagnosed with hepatic sinusoidal obstruction syndrome secondary to PHA. The patient's status further deteriorated and he developed serious hepatic failure. The patient was discharged, and died 3 d later. CONCLUSION: PHA is rare and has a poor prognosis; however, transjugular liver biopsy can be safely performed to aid in diagnosis.
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Ha et al. (2022) conducted a case report in Primary hepatic angiosarcoma manifesting as hepatic sinusoidal obstruction syndrome (n=1). Transjugular liver biopsy was evaluated on Diagnostic yield and clinical outcome. Transjugular liver biopsy successfully diagnosed primary hepatic angiosarcoma manifesting as hepatic sinusoidal obstruction syndrome in a 71-year-old man who subsequently died from severe hepatic failure.
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