title: Metastatic angiosarcoma of the liver preoperatively presenting as giant hemangioma.
abstract: BACKGROUND
  Hepatic angiosarcomas are rare tumors most often associated with exposure to vinyl chloride or other carcinogens. Only a few cases have been published without such a history.
  
  
  METHODS
  We report the case of a 73-year-old woman who was admitted to our medical department with unclear upper abdominal pain, thrombocytopenia and anemia. Both computed tomography and magnet resonance imaging revealed a giant hemangioma in the right liver with multiple small hemangiomas. To cure the problem of thrombocytopenia due to sequestration of blood cells in the hemangioma, we decided to resect the large tumor. Intraoperatively, however, the diagnosis of angiosarcoma with multiple metastases was made. The patient died 6 weeks after surgery.
  
  
  CONCLUSIONS
  Problems in diagnosing angiosarcoma include the brief duration of antecedent symptoms, difficulties in radiological diagnosis, and patients without a history of professional exposure to carcinogens.
authors.affiliation: Department of Visceral and Transplantation Surgery, University of Bern, Switzerland.
authors.forename: T
authors.initials: T
authors.lastname: Kirschstein
authors.forename: D
authors.initials: D
authors.lastname: Aeberli
authors.forename: A
authors.initials: A
authors.lastname: Zimmermann
authors.forename: W
authors.initials: W
authors.lastname: Uhl
authors.forename: M W
authors.initials: MW
authors.lastname: Büchler
mesh_terms: D003937:Diagnosis, Differential; D006391:Hemangioma / Q000175:diagnosis*; D006394:Hemangiosarcoma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D013921:Thrombocytopenia / Q000209:etiology; D014057:Tomography, X-Ray Computed