Lee F I, Smith P M, Bennett B, Williams D M
Department of Gastroenterology, Blackpool Victoria Hospital NHS Trust, Blackpool, Lancashire.
Gut. 1996 Aug;39(2):312-8. doi: 10.1136/gut.39.2.312.
Angiosarcoma of the liver (ASL) has been described in vinyl chloride workers worldwide.
To describe the UK experience of occupationally related ASL.
Twenty patients who died from ASL after exposure to vinyl chloride.
The case records and pathological findings of these 20 patients were reviewed.
Twenty men in the United Kingdom aged 37 to 71 years have developed ASL in association with occupational exposure to vinyl chloride monomer VCM in two factories. All had been exposed to VCM for three to 29 years, the tumour developing nine to 35 years after first exposure. Presenting clinical features included abdominal pain, malaise, jaundice, ascites, and massive hepatomegaly. In most cases the disease progressed rapidly, death occurring within a few weeks from hepatic coma. In 17 cases there was no spread outside the liver. In four cases there had been haemorrhage from oesophageal varices due to non-cirrhotic portal fibrosis diagnosed six to 18 years previously. At necropsy the livers of these men showed considerable, often massive, replacement by tumour, apparently multifocal, with necrosis and haemorrhage.
In view of the long latency between exposure and development of the tumour the full extent of ASL occurrence may not be known until 35 years after the introduction of the Code of Practice in 1975.
全球氯乙烯工人中已出现肝血管肉瘤（ASL）。
描述英国职业相关肝血管肉瘤的情况。
20名因接触氯乙烯后死于肝血管肉瘤的患者。
回顾这20名患者的病例记录和病理检查结果。
英国20名年龄在37至71岁的男性在两家工厂因职业接触氯乙烯单体（VCM）而患上肝血管肉瘤。所有人接触VCM的时间为3至29年，肿瘤在首次接触后9至35年出现。临床表现包括腹痛、不适、黄疸、腹水和肝脏肿大。多数情况下，病情进展迅速，数周内死于肝昏迷。17例患者肿瘤未扩散至肝脏以外。4例患者因6至18年前诊断的非肝硬化性门静脉纤维化导致食管静脉曲张出血。尸检时，这些男性的肝脏显示出大量肿瘤替代，通常为广泛性，呈多灶性，伴有坏死和出血。
鉴于接触与肿瘤发生之间的潜伏期较长，在1975年实施操作规范35年后才可能知晓肝血管肉瘤发生的全貌。
