Abstract
A 64-year-old man presented with fever and right upper abdominal quadrant pain was referred to our hospital. Blood analysis revealed increased inflammatory reaction and an abdominal CT scan showed a 50-mm low density area with irregular margin in the posterior segment of liver. He was emergently admitted with a suspected diagnosis of hepatic abscess. Percutaneous transhepatic biliary drainage performed on the next day did not aspirate purulent fluid but only blood. Furthermore histopathology of a fine needle biopsy specimen revealed atypical cells suggestive of malignancy. A possibility of a tumor derived from the vessel was also suspected. Despite sustained chemotherapy after admission, high fever and increased inflammatory reaction persisted and the hepatic function gradually deteriorated. We considered that hepatic resection was only one therapy for the hepatic lesion if it was malignant, and performed posterior segmentectomy of liver and cholecystectomy on the 22nd hospital day. However, the operation did not result in curative resection. Although fever and abdominal pain temporarily relieved after the operation, he died on the 25th postoperative day. The histopathological diagnosis was hepatic angiosarcoma with concomitant existence of multinucleated osteoclast-like giant cells.
As our case is the first report describing that hepatic angiosarcoma coexisted with osteoclast-like giant cells in Japan, we present our case together with a review of the literature.
