Hepatic Angiosarcoma Masquerading as Hemangioma: A Challenging Differential Diagnosis
Autor(a) principal: | |
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Data de Publicação: | 2017 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8593 |
Resumo: | Hemangiomas are usually diagnosed based on ultrasound findings. The presence of symptoms, rapid growth or atipical imagiological findings should make us consider other diagnoses, including malignant tumors such as angiosarcomas. We describe the case of a previously healthy 46-year-old female without a history of exposure to carcinogens who presented with abdominal pain for two months. Diagnostic work-up revealed elevated gamma-glutamyl transferase and lactate dehydrogenase levels. Abdominal ultrasound described a large nodular lesion in the right lobe of the liver described as a hemangioma. One month later, a computed tomography-scan was made and revealed the same lesion, which had grown from 13.5 to 20 cm, maintaining typical imaging characteristics of a hemangioma. A right hepatectomy was performed and pathology revealed an angiosarcoma. After surgery, a positron emission tomography-computed tomography scan showed hepatic and bone metastasis. The patient started taxane-based chemotherapy and lumbar palliative radiotherapy, but died 10 months after surgery. This case shows how difficult it is to diagnose hepatic angiosarcoma relying only on imaging findings. Two abdominal computed tomography -scans were performed and none suggested this diagnosis. Angiosarcoma is a very aggressive tumour with an adverse prognosis. Surgery is the only curative treatment available. However, it is rarely feasible due to unresectable disease or distant metastasis. |
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Hepatic Angiosarcoma Masquerading as Hemangioma: A Challenging Differential DiagnosisAngiosarcoma Hepático e Hemangioma: Um Diagnóstico ABSTRACTHemangiomaCavernous/diagnosisHemangiosarcoma/diagnosisLiver Neoplasms/diagnosisHemangioma Cavernoso/diagnósticoHemangiossarcoma/diagnósticoNeoplasias Hepáticas/diagnósticoHemangiomas are usually diagnosed based on ultrasound findings. The presence of symptoms, rapid growth or atipical imagiological findings should make us consider other diagnoses, including malignant tumors such as angiosarcomas. We describe the case of a previously healthy 46-year-old female without a history of exposure to carcinogens who presented with abdominal pain for two months. Diagnostic work-up revealed elevated gamma-glutamyl transferase and lactate dehydrogenase levels. Abdominal ultrasound described a large nodular lesion in the right lobe of the liver described as a hemangioma. One month later, a computed tomography-scan was made and revealed the same lesion, which had grown from 13.5 to 20 cm, maintaining typical imaging characteristics of a hemangioma. A right hepatectomy was performed and pathology revealed an angiosarcoma. After surgery, a positron emission tomography-computed tomography scan showed hepatic and bone metastasis. The patient started taxane-based chemotherapy and lumbar palliative radiotherapy, but died 10 months after surgery. This case shows how difficult it is to diagnose hepatic angiosarcoma relying only on imaging findings. Two abdominal computed tomography -scans were performed and none suggested this diagnosis. Angiosarcoma is a very aggressive tumour with an adverse prognosis. Surgery is the only curative treatment available. However, it is rarely feasible due to unresectable disease or distant metastasis.Apesar do diagnóstico de hemangioma ser habitualmente simples e baseado na ecografia, a presença de sintomas, o crescimento rápido ou a presença de atipias imagiológicas devem-nos fazer considerar a hipótese de outras entidades, algumas delas malignas como o angiossarcoma. É descrito o caso de doente do sexo feminino de 46 anos, previamente saudável sem exposição a carcinogéneos, refere queixas de dor abdominal durante dois meses. O estudo analítico revelou elevação da gama glutamil transferase e lactato desidrogenase e a ecografia abdominal evidenciou uma lesão nodular de grandes dimensões no lobo direito do fígado, descrita como hemangioma. Um mês mais tarde, realizou uma tomografia computadorizada abdominal que revelou aumento das dimensões da lesão (13,5 para 20 cm), mantendo características imagiológicas de hemangioma. A doente foi submetida a hepatectomia direita e a histologia revelou a presença de angiossarcoma. Após cirurgia, uma tomografia por emissão de positrões-tomografia computadorizada evidenciou metastização hepática e óssea. A doente foi submetida a radioterapia e quimioterapia paliativa com paclitaxel, tendo falecido 10 meses após a cirurgia. Este caso exemplifica a dificuldade do diagnóstico do angiosarcoma baseado apenas nos exames de imagem. Foram realizadas duas tomografias computadorizadas abdominais e nenhuma sugeriu o diagnóstico. Os angiossarcomas são tumores muito agressivos com prognóstico reservado, sendo a cirurgia o único tratamento curativo. No entanto, raramente é realizada devido a doença irressecável ou disseminação à distância.Ordem dos Médicos2017-10-31info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfimage/jpegimage/jpegimage/jpegapplication/pdfapplication/pdfapplication/pdfapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8593oai:ojs.www.actamedicaportuguesa.com:article/8593Acta Médica Portuguesa; Vol. 30 No. 10 (2017): October; 750-753Acta Médica Portuguesa; Vol. 30 N.º 10 (2017): Outubro; 750-7531646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8593https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8593/5209https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8593/8990https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8593/8993https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8593/8994https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8593/9028https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8593/9029https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8593/9030https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8593/9267Direitos de Autor (c) 2017 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessGarcia, Ana RitaRibeiro, JoãoGervásio, HelenaSousa, Francisco Castro e2022-12-20T11:05:34Zoai:ojs.www.actamedicaportuguesa.com:article/8593Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:19:36.942977Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Hepatic Angiosarcoma Masquerading as Hemangioma: A Challenging Differential Diagnosis Angiosarcoma Hepático e Hemangioma: Um Diagnóstico ABSTRACT |
title |
Hepatic Angiosarcoma Masquerading as Hemangioma: A Challenging Differential Diagnosis |
spellingShingle |
Hepatic Angiosarcoma Masquerading as Hemangioma: A Challenging Differential Diagnosis Garcia, Ana Rita Hemangioma Cavernous/diagnosis Hemangiosarcoma/diagnosis Liver Neoplasms/diagnosis Hemangioma Cavernoso/diagnóstico Hemangiossarcoma/diagnóstico Neoplasias Hepáticas/diagnóstico |
title_short |
Hepatic Angiosarcoma Masquerading as Hemangioma: A Challenging Differential Diagnosis |
title_full |
Hepatic Angiosarcoma Masquerading as Hemangioma: A Challenging Differential Diagnosis |
title_fullStr |
Hepatic Angiosarcoma Masquerading as Hemangioma: A Challenging Differential Diagnosis |
title_full_unstemmed |
Hepatic Angiosarcoma Masquerading as Hemangioma: A Challenging Differential Diagnosis |
title_sort |
Hepatic Angiosarcoma Masquerading as Hemangioma: A Challenging Differential Diagnosis |
author |
Garcia, Ana Rita |
author_facet |
Garcia, Ana Rita Ribeiro, João Gervásio, Helena Sousa, Francisco Castro e |
author_role |
author |
author2 |
Ribeiro, João Gervásio, Helena Sousa, Francisco Castro e |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Garcia, Ana Rita Ribeiro, João Gervásio, Helena Sousa, Francisco Castro e |
dc.subject.por.fl_str_mv |
Hemangioma Cavernous/diagnosis Hemangiosarcoma/diagnosis Liver Neoplasms/diagnosis Hemangioma Cavernoso/diagnóstico Hemangiossarcoma/diagnóstico Neoplasias Hepáticas/diagnóstico |
topic |
Hemangioma Cavernous/diagnosis Hemangiosarcoma/diagnosis Liver Neoplasms/diagnosis Hemangioma Cavernoso/diagnóstico Hemangiossarcoma/diagnóstico Neoplasias Hepáticas/diagnóstico |
description |
Hemangiomas are usually diagnosed based on ultrasound findings. The presence of symptoms, rapid growth or atipical imagiological findings should make us consider other diagnoses, including malignant tumors such as angiosarcomas. We describe the case of a previously healthy 46-year-old female without a history of exposure to carcinogens who presented with abdominal pain for two months. Diagnostic work-up revealed elevated gamma-glutamyl transferase and lactate dehydrogenase levels. Abdominal ultrasound described a large nodular lesion in the right lobe of the liver described as a hemangioma. One month later, a computed tomography-scan was made and revealed the same lesion, which had grown from 13.5 to 20 cm, maintaining typical imaging characteristics of a hemangioma. A right hepatectomy was performed and pathology revealed an angiosarcoma. After surgery, a positron emission tomography-computed tomography scan showed hepatic and bone metastasis. The patient started taxane-based chemotherapy and lumbar palliative radiotherapy, but died 10 months after surgery. This case shows how difficult it is to diagnose hepatic angiosarcoma relying only on imaging findings. Two abdominal computed tomography -scans were performed and none suggested this diagnosis. Angiosarcoma is a very aggressive tumour with an adverse prognosis. Surgery is the only curative treatment available. However, it is rarely feasible due to unresectable disease or distant metastasis. |
publishDate |
2017 |
dc.date.none.fl_str_mv |
2017-10-31 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8593 oai:ojs.www.actamedicaportuguesa.com:article/8593 |
url |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8593 |
identifier_str_mv |
oai:ojs.www.actamedicaportuguesa.com:article/8593 |
dc.language.iso.fl_str_mv |
eng |
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eng |
dc.relation.none.fl_str_mv |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8593 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8593/5209 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8593/8990 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8593/8993 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8593/8994 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8593/9028 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8593/9029 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8593/9030 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8593/9267 |
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Direitos de Autor (c) 2017 Acta Médica Portuguesa info:eu-repo/semantics/openAccess |
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Direitos de Autor (c) 2017 Acta Médica Portuguesa |
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openAccess |
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application/pdf image/jpeg image/jpeg image/jpeg application/pdf application/pdf application/pdf application/pdf |
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Ordem dos Médicos |
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Ordem dos Médicos |
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Acta Médica Portuguesa; Vol. 30 No. 10 (2017): October; 750-753 Acta Médica Portuguesa; Vol. 30 N.º 10 (2017): Outubro; 750-753 1646-0758 0870-399X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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