A Case of Hepatic Hemangiosarcoma Associated with Kasabach-Merritt Syndrome

Abstract

A 61-year-old woman was referred to our hospital because of a hepatic mass detected by abdominal ulttrasonography at a medical examination. The mass was diagnosed as cavernous hemangioma of the liver by abdominal computed tomography (CT). After 9 months, we performed CT again because of chest and abdominal pain. This CT revealed enlargement of the hepatic tumor. Abdominal angiography showed a peripheral stain in addition to the cotton wool appearance and magnetic resonance imaging showed heterogeneous intensity on the T2 image. We diagnosed her condition as hepatic hemangiosarcoma and carried out transcatheter arterial embolization (TAE), hepatic arterial infusion of interleukin-2 (IL-2) and steroid therapy. Her condition was markedly improved for several weeks. However, the symptoms appeared again thereafter and she died of respiratory failure 4 months after the appearance of the symptoms. The autopsy revealed that the right lobe is occupied nodular tumors and histologically the tumors was diagnosed as hepatic hemangiosarcoma. Although hepatectomy should be performed as the first choice for hepatic hemangiosarcoma, TAE, hepatic arterial infusion of I1-2 or stroid therapy can be beneficial for unresectable tumors.