Chaudhary P, Bhadana U, Singh R A K, Ahuja A
Lady Hardinge Medical College and Associated Dr Ram Manohar Lohia Hospital, New Delhi, India.
Lady Hardinge Medical College and Associated Dr Ram Manohar Lohia Hospital, New Delhi, India.
Eur J Surg Oncol. 2015 Sep;41(9):1137-43. doi: 10.1016/j.ejso.2015.04.022. Epub 2015 May 14.
Primary hepatic angiosarcoma is a rare, aggressive tumor; composed of spindle or pleomorphic cells that line, or grow into, the lumina of pre-existing vascular spaces like sinusoids and terminal hepatic venules; with only about 200 cases diagnosed annually worldwide but it is the most common primary malignant mesenchymal tumor of the liver in adults and accounts for 2% of all primary hepatic malignancies. HAS occurs in association with known chemical carcinogens, but 75% of the tumors have no known etiology. Patients present with vague symptoms like abdominal pain, weight loss, fatigue or an abdominal mass. Hepatic angiosarcoma is usually multicentric and involves both lobes, entire liver may also found to be involved. CD31 is the most reliable marker. These tumors lack specific features on imaging, so, pathological diagnosis is necessary. There are no established treatment guidelines because of low frequency and aggressive nature of tumor, chemotherapy is only palliative, liver resection is indicated for solitary mass and liver transplant is contraindicated. The aim of this article is to comprehensively review all the available literature and to present detailed information and an update on primary hepatic angiosarcoma.
原发性肝血管肉瘤是一种罕见的侵袭性肿瘤;由梭形或多形性细胞组成,这些细胞排列在或长入预先存在的血管腔隙(如血窦和终末肝小静脉)内;全球每年确诊病例约200例,但它是成人中最常见的原发性肝脏恶性间叶性肿瘤,占所有原发性肝脏恶性肿瘤的2%。肝血管肉瘤与已知化学致癌物有关,但75%的肿瘤病因不明。患者表现为腹痛、体重减轻、疲劳或腹部肿块等模糊症状。肝血管肉瘤通常为多中心性,累及两叶,整个肝脏也可能受累。CD31是最可靠的标志物。这些肿瘤在影像学上缺乏特异性特征,因此需要病理诊断。由于肿瘤发病率低且具有侵袭性,尚无既定的治疗指南,化疗仅为姑息性治疗,孤立性肿块可行肝切除术,肝移植为禁忌。本文旨在全面回顾所有现有文献,并提供原发性肝血管肉瘤的详细信息和最新进展。