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Query: UMLS:C0012739 (disseminated intravascular coagulation)
 8,673 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

Analysis of four cases of hemangiosarcoma of the liver and review of the literature indicate that these tumors are either predominantly cystic and fairly well differentiated or are more solid and poorly differentiated. Well-differentiated hemangiosarcomas may resemble peliosis hepatis or other benign conditions. The tumor was associated disseminated intravascular coagulation and fibrinolysis syndrome in one of our cases. One of our patients had received thorium dioxide (Thorotrast) but none seemed to have been exposed to arsenicals or to vinyl chloride.
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PMID:Hemangiosarcoma of the liver. Spectrum of morphologic changes and clinical findings. 109 26

The hemostasis profiles of 24 dogs with histologically confirmed hemangiosarcoma were prospectively evaluated. Microangiopathic hemolysis was defined as the presence of schistocytes; disseminated intravascular coagulation was defined as 1) thrombocytopenia, 2) fibrin(ogen) degradation products greater than 10 micrograms/mL, 3) prolongation of one or more coagulation times (activated partial thromboplastin time or one-stage prothrombin time) by greater than 25% of the control, 4) fragmented red blood cells (greater than or equal to 1+ based on a semiquantitative grading scale), and 5) fibrinogen less than or equal to 80 mg/dL. Three of the five criteria listed above had to be met for disseminated intravascular coagulation to be diagnosed. Fifty percent of the dogs were considered to have disseminated intravascular coagulation at presentation. Thrombocytopenia was present in 75% of the dogs and was the most common abnormality. The mean platelet count was 137,800/microL. Twenty-five percent of the dogs died as a result of the hemostatic abnormalities. Only 12% of the dogs had microangiopathic hemolysis without other evidence of disseminated intravascular coagulation. Hemostatic abnormalities are present in many dogs with hemangiosarcoma at the initial clinical presentation and represent an important clinical finding.
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PMID:Hemostatic abnormalities in dogs with hemangiosarcoma. 202 11

A case of metastatic angiosarcoma of the ovary, complicated by disseminated intravascular coagulation, is described. The tumour was diagnosed by histopathologic examination and immunohistochemical studies. Angiosarcoma of the ovary, although extremely rare, appears to be a highly malignant neoplasm with an aggressive course and effective therapy is unknown.
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PMID:Metastatic angiosarcoma of the ovary. 204 84

A female patient with intravitally diagnosed splenic angiosarcoma is described. Progress of the cancerous process was attended by the development of consumption coagulopathy with profound fibrinogenopenia and thrombocytopenia. In this case the DIC syndrome was characterized by the lack of systemic fibrinolysis activation. The rupture of the cavernous tumor of the spleen and profound disorders of hemostasis determined profuse intraperitoneal hemorrhage and the patient's death. Diagnostic criteria that contribute to early recognition of splenic angiosarcoma are suggested.
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PMID:[Angiosarcoma of the spleen with consumption coagulopathy]. 228 95

Primary renal angiosarcoma is a very rare malignant tumor that closely mimics the more common renal cell adenocarcinoma (hypernephroma) in radiologic appearance. Both tumors are hypervascular masses and the diagnosis must be confirmed histologically. However, in the presence of a tumor with a capsular blood supply, and in the absence of venous invasion, the diagnosis of renal angiosarcoma may be suggested, especially in a patient with a new onset of consumption coagulopathy.
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PMID:Primary renal angiosarcoma mimicking a renal cell carcinoma. 273 70

Hemangioendothelioma is seldom seen in adults. Its severe evolution is due, not so much to the exceptional transformation into hemangiosarcoma, but mainly to haemorrhagic complications by rupture or consumption coagulopathy and to severe cardiac insuffficiency secondary to arteriovenous shunts. The case reported here concerns a 64 year-old woman presenting pain in the left hypochondrium and splenomegaly. A splenectomy was performed and the histological findings were compatible with the diagnosis of hepato-splenoganglionic hemangioendothelioma. The evolution was unfavorable. The patient died a few months later in a picture of haemorrhagic syndrome and cardiac insufficiency. Histological findings on autopsy specimens indicated a cavernous hemangioma. The treatment of these diffuse hemangiomas is a difficult one. Hepatic artery ligation has been advocated in certain desperate situations. Nevertheless, because of a collateral circulation, recurrences are frequent.
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PMID:[Lymph node-hepatosplenic hemangioma in an adult with consumption coagulopathy and fatal cardiac insufficiency]. 343 34

A case of angiosarcoma of the liver and the spleen following vinyl chloride exposure is described. The main symptoms in clinical diagnosis were microangiopathic hemolysis, disseminated intravascular coagulation, hepatosplenomegaly and exposure to vinyl chloride thirty years ago. It is the first case in which liver and spleen are involved in angiosarcoma due to vinyl chloride exposure. The tumor cells showed angioformative and solid histiocytoid growth with erythrophagocytosis.
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PMID:[Microangiopathic hemolytic anemia, erythrophagocytosis and consumption coagulopathy in vinyl chloride-induced hemangiosarcoma of the spleen and liver]. 361 92

During the period 1975 to 1984, a histopathologic diagnosis of primary cardiac hemangiosarcoma was made in 38 dogs at Angell Memorial Animal Hospital. The diagnosis was confirmed by exploratory thoracotomy in 16 cases and at necropsy in 22 cases. At the time of exploratory thoracotomy, 7 dogs were euthanatized because of nonresectability of the primary tumor and/or gross metastatic disease. In 9 dogs, the tumor was resected by removing part of the right atrium. Complications included atrial and ventricular arrhythmias, anemia, disseminated intravascular coagulation, and pneumonia. Prolonged and multiple hospitalizations were a common feature of the postoperative period. Adjuvant therapy was not utilized in any case. The mean survival time was 4 months (2 days to 8 months).
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PMID:Cardiac hemangiosarcoma in the dog: a review of 38 cases. 405 16

The authors describe three cases of hepatic angiosarcoma diagnosed at postmortem examination, two of them being associated to thorium dioxide. The low incidence of these tumors amongst the general population is commented upon, and an update is made on the factors involved in their appearance, with special mention of thorium dioxide. An analysis of the clinical picture of the disease is undertaken, emphasizing its diagnostic difficulties. A tentative diagnosis can be made on the basis of clear-cut epidemiological data and or the presence of increased radiological density over the liver, spleen and paraaortic lymph nodes in the cases associated to thorium dioxide. Two of the reported patients presented hemolytic anemia, and disseminated intravascular coagulation, respectively; these findings, although nonspecific, may suggest the diagnosis in the presence of a toxic clinical picture or one of the above mentioned factors. The diagnosis should be made by the usual techniques utilized clinically to detect space occupying lesions within the liver. The evolution of such patients is rapidly progressive, with a fatal outcome within three to six months after beginning of symptoms.
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PMID:[Hepatic angiosarcomas]. 719 5


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