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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

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

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

Angiosarcoma most frequently occurs in the skin of the head and neck region of elderly persons, lymphedematous limbs, or in deep soft tissue but only rarely has been described to occur in the female genital tract. Four cases of angiosarcoma of the ovary are described herein. They occurred in patients 25 to 42 years old (median, 31 years). The most common clinical presentation was abdominal pain. All of the tumors were unilateral, hemorrhagic, and ranged from 3.5 cm to 14 cm (median, 13 cm). The histologic appearance of the tumors was varied, and often the vascular nature of the tumor was not apparent immediately. Some of the tumors had a fascicular growth pattern composed of spindle-shaped cells with ovoid nuclei and ample eosinophilic cytoplasm closely mimicking leiomyosarcoma. Other tumors resembled ovarian yolk sac tumor with a reticular growth pattern, whereas, in other areas, cystic structures lined by hobnailed hyperchromatic enlarged nuclei simulated clear cell carcinoma of the ovary. Despite these misleading morphologic findings, all cases were characterized, at least focally, by vasoformative channels or discrete cytoplasmic vacuoles, and all were immunoreactive for vascular markers. Two patients with spread of tumor outside of the ovary died 1 month and 2 years after initial diagnosis, respectively. Two patients with tumor confined to the ovary are alive without evidence of disease 3 and 14 months after diagnosis, respectively. The differential diagnosis of this unusual neoplasm is discussed, and the literature is reviewed.
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PMID:Angiosarcoma of the ovary: clinicopathologic and immunohistochemical analysis of four cases with a broad morphologic spectrum. 959 33

Angiosarcoma developed at the site of a Dacron vascular prosthesis 8 years after an aortobifemoral bypass graft insertion. The tumor was composed of epithelioid cells, which showed positive staining for cytokeratin and expression of the common endothelial markers CD31, CD34, and von Willebrand factor. Ultrastructural examination showed aggregates of large cells with intercellular lumina and focal perinuclear whorls of intermediate filaments. The patient, who had abdominal pain and weight loss, died of disseminated pelvic and abdominal disease 6 months after diagnosis. Sarcomas associated with vascular Dacron grafts and angiosarcomas associated with metal or polymer foreign bodies are rare. Their development is probably analogous to the common experimental development of foreign body-associated sarcomas in rodents. Physicians caring for patients with vascular grafts or metal foreign bodies should be aware of this complication.
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PMID:Epithelioid angiosarcoma associated with a Dacron vascular graft. 1055 12

Angiosarcoma is a rare malignant tumor which occurs frequently in the skin and soft subcutis. Moreover, primary gastrointestinal angiosarcomas are very rare. This tumor manifests as non-specific symptoms such as gastrointestinal bleeding, abdominal pain and nausea. The diagnosis is often made at an advanced stage. Surgery, chemotherapy and radiotherapy are the mainstay of treatment. However, the prognosis is very poor. We report a case of primary angiosarcoma of the small intestine presenting as recurrent gastrointestinal bleeding. A 54-year-old man was admitted with recurrent gastrointestinal bleeding. An abdominal CT scan revealed an ileo-ileal intussusception. Segmental resection was performed with ileo-ileal anastomosis. The ileal mass was diagnosed as angiosarcoma on immunohistochemical stain. He received 3 cycles of chemotherapy, but died 5 months after the diagnosis.
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PMID:[A case of primary angiosarcoma of small intestine presenting as recurrent gastrointestinal bleeding]. 1630 55

Angiosarcoma of the gastrointestinal tract is a very rare malignancy with only a few cases reported in the literature. The case of a 60-year-old woman who presented with abdominal pain and a sigmoid mass on computed tomography (CT) scan is reported. Upon exploration, the patient was found to have a subserosal hemorrhagic mass. Angiosarcoma of the sigmoid colon was diagnosed upon pathological examination. The patient developed subsequent recurrence of her disease with distant metastasis. Approximately 4 months later, she expired. Angiosarcoma of the gastrointestinal tract is a very aggressive malignant tumor. The primary treatment is surgical excision. The role of adjuvant therapy is not well established.
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PMID:Sigmoid colon angiosarcoma with intraperitoneal bleeding and early metastasis. 1732 Aug 8

We report a case of an 84-year-old male patient with primary small intestinal angiosarcoma. The patient initially presented with anemia and melena. Consecutive endoscopy revealed no signs of upper or lower active gastrointestinal bleeding. The patient had been diagnosed 3 years previously with an aortic dilation, which was treated with a stent. Computed tomography suggested an aorto-intestinal fistula as the cause of the intestinal bleeding, leading to operative stent explantation and aortic replacement. However, an aorto-intestinal fistula was not found, and the intestinal bleeding did not arrest postoperatively. The constant need for blood transfusions made an exploratory laparotomy imperative, which showed multiple bleeding sites, predominately in the jejunal wall. A distal loop jejunostomy was conducted to contain the small intestinal bleeding and a segmental resection for histological evaluation was performed. The histological analysis revealed a less-differentiated tumor with characteristic CD31, cytokeratin, and vimentin expression, which led to the diagnosis of small intestinal angiosarcoma. Consequently, the infiltrated part of the jejunum was successfully resected in a subsequent operation, and adjuvant chemotherapy with paclitaxel was planned. Angiosarcoma of the small intestine is an extremely rare malignant neoplasm that presents with bleeding and high mortality. Early diagnosis and treatment are essential to improve outcome. A small intestinal angiosarcoma is a challenging diagnosis to make because of its rarity, nonspecific symptoms of altered intestinal function, nonspecific abdominal pain, severe melena, and acute abdominal signs. Therefore, a quick clinical and histological diagnosis and decisive measures including surgery and adjuvant chemotherapy should be the aim.
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PMID:Small intestine bleeding due to multifocal angiosarcoma. 2319 97

We present a case of angiosarcoma in small bowel, presenting with partial small bowel obstruction in a 79-year-old man with no history of radiation, chemotherapy, toxin exposure, or previous operative intervention. Angiosarcoma of small bowel is a rare entity which may present with nausea, abdominal pain, recurrent bleeding, and usually a history of prior radiation or exposure to specific toxins (polyvinyl chloride). Angiosarcoma of small bowel tends to spread rapidly and has a poor prognosis. We review the surgical and oncologic challenges. We report unique macroscopic findings of raised hyperemic margins, which are suggestive of a vasogenic lesion and the histologic feature of a partially retiform pattern with dense basement membrane material in an otherwise poorly differentiated lesion.
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PMID:Angiosarcoma of small bowel presenting with obstruction: novel observations on a rare diagnostic entity with unique clinical presentation. 2319 86


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