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Angiosarcoma of the liver

Alexey Kryvenko, medical expert
Last reviewed: 05.07.2025

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Liver angiosarcoma is a rare, highly malignant tumor that is difficult to differentiate from hepatocellular carcinoma.

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Causes of liver angiosarcoma

Angiosarcoma is a group of diseases that involve damage to the sinusoidal barrier, which also includes peliosis hepatis and dilated sinuses. These three conditions may be associated with toxic effects of vinyl chloride, arsenic, thorotrast, and anabolic steroids. Angiosarcoma may complicate the course of neurofibromatosis.

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Histology of liver angiosarcoma

Histological examination of the tumor reveals blood-filled cavernous sinuses lined with malignant anaplastic endothelial cells. These cells may partly resemble vascular epithelial cells at the earliest stages of development in embryogenesis. Highly differentiated tumors resemble peliosis hepatis. The liver is enlarged and contains multiple nodes resembling cavernous hemangioma.

Giant cells, solid sarcomatous foci, and intrasinusoidal tumor spread with invasion into the portal and hepatic veins are clearly visible. Proliferation of bile ducts and hypertrophy of sinusoidal lining cells are observed in the areas of liver tissue adjacent to the tumor.

Tumor cells can express factor VIII-associated antigen, which is a marker of endothelial cells.

Symptoms of liver angiosarcoma

Liver angiosarcoma develops in older people. It manifests itself with symptoms of hepatocellular liver disease, weight loss and fever, accompanied by rapid deterioration of the patient's condition, development of cachexia, hemorrhagic ascites; death occurs within 2 years from the onset of the first symptoms.

Noise is sometimes heard above the liver. The tumor may destroy platelets and develop DIC syndrome. Sometimes the disease takes a protracted course with the development of ascites and hepatomegaly over many years.