Hepatic hemangiosarcoma: imaging findings and differential diagnosis

Primary hepatic angiosarcoma is a rare mesenchymal tumor of the liver that usually presents with nonspecific symptoms in elderly men. We present four cases of hepatic hemangiosarcoma and discuss the imaging characteristics of this entity. Our series shows that this tumor is not uncommon in younger p atients with no associated risk factors such as previous exposure to thorot rast or vinyl chloride. Our experiences on a limited number of patients sug gests that the combined use of angiography and dual-phase helical CT provid es a better identification of the tumor and its complications. Analysis of imaging studies in patients with hepatic hemangiosarcoma reveals hypervascu lar lesions. Common complications were portal vein thrombosis, Budd-Chiari syndrome, as well as arterio-venous or arterio-portal shunts. Due to the va scularity of the tumor, percutaneous liver biopsy is hazardous.