2024 Volume 65 Issue 3 Pages 121-130
A woman in her 60s visited our department with a chief complaint of dyspnea on exertion and pain in the right hypochondrium. Ten intrahepatic cysts, one with a maximum diameter of 14 cm, were found in her liver. Angiosarcoma in conjunction with simple hepatic cysts is rare. The intrahepatic cystic lesions were undetected three years earlier. Endoscopic ultrasonography, computed tomography, magnetic resonance imaging, integrated positron emission tomography/computed tomography, gastroscopy, colonoscopy, contrast-enhanced ultrasonography, and cytology by cystocentesis were performed to investigate malignancy, but none of those tests revealed malignant findings. Nevertheless, based on the patient's clinical course, a diagnosis of malignancy was made, and an extended resection of the right hepatic lobe was performed. The large cyst was a neoplastic lesion with a vascular-like structure, whose inner surface was lined with atypical CD31- and CD34-positive cells. The lesion was pathologically diagnosed as angiosarcoma.
