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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Four cases of hepatic angiosarcoma are reported with a review of 99 other cases in the English literature. Angiosarcoma of the liver is associated with chronic exposure to thorotrast, vinyl chloride, arsenicals, radium and possibly copper and with chronic idiopathic hemochromatosis. Although 40% of patients have hepatic fibrosis or cirrhosis at autopsy, the nature of the association between chronic liver disease and hepatic angiosarcoma is unknown. The clinical presentation of hepatic angiosarcoma is nonspecific with abdominal pain, weakness and weight loss common complaints and with hepatomegaly, ascites and jaundice common findings. Liver function tests are usually abnormal but there is no one liver function test or set of tests specific for the tumor. The occurrence of thrombocytopenia and disseminated intravascular coagulation is characteristic of hepatic angiosarcoma and may be related to local consumption of clotting factors and formed blood elements in the tumor. Catastrophic intraabdominal bleeding is also characteristic and occurs in one-fourth of all cases. This complication is likely related to the high incidence of clotting abnormalities and the vascular nature of the neoplasm. Selective hepatic arteriogram and open liver biopsy are the foundations of diagnostic evaluation. Percutaneous liver biopsy should be avoided. Failure to appreciate the possibility of hepatic angiosarcoma in the proper clinical setting, leading to blind percutaneous biopsy, may result in failure to make the diagnosis at the cost of significant morbidity and mortality. Survival of patients with hepatic angiosarcoma is brief; only 3% live longer than 2 years. Treatment of the tumor to date is empirical. There are probably a few patients who might benefit from radical surgery with curative intent. For all others chemotherapy is indicated. Adriamycin is active against hepatic angiosarcoma, but optimal dose and mode of administration require further investigation. Further study is also required to delineate the cause of hepatic angiosarcoma in the 60% of cases without definite epidemiologic association.
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PMID:The clinical features of hepatic angiosarcoma: a report of four cases and a review of the English literature. 36 8

Fifteen male workers exposed to vinyl chloride developed angiosarcoma of the liver. Thirteen died of disease and two are currently living for short periods after diagnosis. Their ages ranged from 36 to 58 years (average 47.5 years). Their exposure time ranged from 4 to 27.8 years (average 16.9 years). The most common presenting symptoms were fatigue, weight loss, and abdominal pain. Hepatomegaly followed by splenomegaly were the most common physical findings. Biochemical profiles yielded variable results and proved to be of little value in the detection or diagnosis. Of eight patients autopsied, distant organ involvement was present in two cases, duodenal involvement in one, and direct extension of tumor to adjacent organs or tissues in four additional ones. The remainder, diagnosed by open liver biopsy, revealed no tumor extension. The gross features of the tumors were hemorrhagic necrosis, cystic degeneration, fibrosis, and apparent multicentricity. The histologic features were those of the typical angiosarcoma found in a variety of sites with a wide range of cellular differentiation. The histologic diagnosis was often impaired by the extensive tumor necrosis. Elsewhere in the liver subcapsular fibrosis, a distinct type of portal fibrosis, and endothelial cell hyperplasia with or without sinusoidal dilatation were noted. The reduction of industrial chemical exposure has already been achieved and will hopefully eliminate this chemically related tumor in the future. There is, however, a significant group of previously exposed workers who will require careful monitoring to detect functional abnormalities of the liver and possible early neoplastic changes.
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PMID:Clinical and morphologic features of hepatic angiosarcoma in vinyl chloride workers. 94 81

Hepatocellular carcinoma is a malignant tumor derived from hepatocytes. It is the most frequent of primary liver cancers. In 90% of the cases, it occurs in a cirrhotic liver and is now more and more detected by ultrasonographic screening of cirrhotic patients. Hepatocellular carcinoma can also be diagnosed at a more advanced stage, when complications, such as ascites, jaundice or digestive hemorrhage, occur. CT scan and magnetic resonance imaging are useful to confirm ultrasonographic findings, but angiography with infusion of Lipiodol in hepatic artery followed by CT scan remains the most sensitive method for diagnosis. Intrahepatic cholangiocarcinoma is derived from intrahepatic bile duct cells and does not occur in a preexisting cirrhotic liver. Diagnosis is usually late. Clinical features are those of hepatic malignancy with jaundice and abdominal pain. Morphological examination of the liver shows an intrahepatic tumor, sometimes associated with a dilatation of the surrounding bile ducts. Other primary malignancies are very rare. Fibrolamellar carcinoma presents as an abdominal mass occurring in a young adult with a non cirrhotic liver. Prognosis is better than that of hepatocellular carcinoma. Cystadenocarcinoma is a cystic tumor of bile ducts that can develop in a preexisting cystadenoma. Angiosarcoma is a highly malignant tumor derived from sinusoidal endothelial cells. Exposure to various carcinogens is found in 30% of the cases. Epithelioid hemangio-endothelioma differs from angiosarcoma by its occurrence in young adults and a more favorable prognosis.
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PMID:[Clinical symptomatology and radiological aspects of primary cancers of the liver]. 145 34

A case of angiosarcoma of the large bowel is presented. The tumor occurred in a 16-year-old girl who presented with lower abdominal pain and rectal bleeding. A sigmoid colectomy was performed. Although macroscopic omental and pelvic peritoneal metastases were noted at operation, she did not receive adjuvant therapy and was alive and well more than three years after surgery. The literature on colonic angiosarcoma is also reviewed.
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PMID:Angiosarcoma of the colon. Report of a case with long-term survival. 218 13

A 60-year-old man with primary splenic hemangiosarcoma (PSH) presented with weakness, weight loss, abdominal pain, and anemia. Physical examination revealed hepatomegaly, ascites, and firm, huge splenomegaly. Ultrasonography showed many nodular structures characterized by hypoechogenic and hyperechogenic areas. The patient also had portal hypertension, which was confirmed by physical findings and by measurement of portal vein pressure during operation. A liver-spleen scan using Tc-99m sulfur colloid and Tc-99m labeled heat denatured erythrocytes failed to demonstrate any splenic uptake, a reliable feature of functional asplenia. Although on a total body scan with Ga-67 citrate there was no splenic uptake, there was gallium uptake in the liver, where the presence of the metastatic lesion was histopathologically verified and confirmed by operation. There was also uptake in the middle zones of the lungs. Ga-67 citrate imaging appears to be helpful in the diagnosis of metastasis of PSH, and PSH can rarely cause portal hypertension.
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PMID:Functional asplenia and portal hypertension in a patient with primary splenic hemangiosarcoma. 234 Jun 75

We report the first case of primary angiosarcoma of the adrenal gland, to our knowledge. A 54-year-old man presented with chronic left upper quadrant abdominal pain, and a left adrenal mass was subsequently found on computed tomography of the abdomen. The tumor was surgically removed and a diagnosis of adrenal angiosarcoma, supported by findings of immunoperoxidase and ultrastructural studies, was made. Seven months later, recurrent tumor resulted in an en bloc resection of lateral gastric wall, tail of pancreas, left kidney, and spleen. One year after the initial surgery, the patient was free of tumor. Angiosarcoma should be added to the list of possible primary adrenal gland malignancies.
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PMID:Angiosarcoma of the adrenal gland. 317 32

Angiosarcoma is a rare malignant tumor originating from vascular endothelial cells. We have experienced a case of 17-year-old man, who had angiosarcoma in the pineal region and the liver. Patient's initial symptom was headache and CT scan revealed a high density mass in the pineal region with obstructive hydrocephalus. After the radiation therapy, the tumor was disappeared completely on CT scan. One year later, he developed abdominal pain, and CT scan and angiogram revealed multiple angioma like lesions in the liver. The mass in the pineal region showed concomitant regrowth, and finally, the patient was died of abdominal hemorrhage. At autopsy, pineal tumor and hepatic tumor were both angiosarcomas, although it was uncertain which was the original tumor.
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PMID:[Angiosarcoma of the liver and pineal region]. 338 82

A 28-year-old woman was admitted six months before her death because of abdominal pain, anemia and hepatosplenomegaly. Clinical diagnosis by biopsy examination was primary hepatic angiosarcoma. The autopsy revealed about 700 ml of bloody ascites. The spleen weighed 510 g, and was completely replaced by dark grayish-red tumors. The enlarged liver was 6,560 g and revealed multiple tumor nodules. Microscopically, the tumor cells formed irregular vascular spaces. Factor VIII-related antigens were stained in the tumor cells. Zonula adherens was observed also by electron microscopic observation.
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PMID:[An autopsy case of primary splenic hemangiosarcoma]. 407 65

Since the initial report in 1973 of 7 women who developed liver tumors while using oral contraceptives (OCs) over 300 cases have been reported. Hapatic tumors associated with OCs are benign (focal nodular hyperplasia or hepatocellular adenoma) or malignant (hepatocellular carcinoma, angiosarcoma, or cholangiocellular carcinoma). Mestranol is the main estrogen related to the development of hepatic adenoma but other OCs containing combinations of ethinyl estradiol, ethyl estradiol, mestranol, norethynodrel, norethisterone, and norgestrol are also associated with the tumors. Longterm OC users have an estimated annual incidence of 3-4/100,000. Hepatic tumors may present with abdominal pain or be an incidental finding on physical examination or at laparotomy. Diagnosis is confirmed by scintigraphy, echography, CT-scanning, angiography, or laparoscopy. Dynamic isotopic scanning may help differentiate between benign and malignant lesions. Symptomatic benign tumors and malignant tumors are best treated by partial hepatectomy and a ban on estrogens. The use of OCs should be forbidden following resections. Surgery is indicated for patients with persistent or recurrent pain, those with intraperitoneal hemorrhage and those in whom a carcinoma is suspected. The administration of synthetic estrogens to experimental animals results in a variety of morphological and functional changes within the hepatocyte. Other possibilities are that the estrogen potentiates the carcinogenicity of other compounds, either by changing their metabolism or by interfering with their excretion due to the cholestatic effects of synthetic estrogens.
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PMID:Oral contraceptives and hepatic tumors. 708 79

A 60-year-old Filipino man, who presented with left sided abdominal pain and weight loss, was found to have splenomegaly, an abnormal spleen scan and a leukemoid reaction. Primary splenic hemangiosarcoma was found at splenectomy. Metastases first occurred in the cervical lymph nodes two years after diagnosis. Despite treatment with doxorubicin and radiation therapy there was recurrence in lymph nodes and scan evidence of liver and bone metastases. The patient died 38 months after diagnosis. A liver-spleen scan is helpful in establishing an early diagnosis, and splenectomy before rupture occurs is advisable. The role of chemotherapy needs to be defined.
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PMID:Primary hemangiosarcoma of the spleen associated with leukocytosis and abnormal spleen scan. 719 68


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