title: Sequential development of hepatocellular carcinoma and liver angiosarcoma in a vinyl chloride-exposed worker.
abstract: Strong experimental and clinical evidences have definitely linked occupational vinyl chloride exposure to development of angiosarcoma of the liver. In contrast, despite the International Agency for Research on Cancer having included vinyl chloride among the causes of hepatocellular carcinoma, the association between vinyl chloride exposure and hepatocellular carcinoma remains debated. This issue is relevant, because occupational exposure to high levels of vinyl chloride may still occur. We report a unique case of sequential occurrences of hepatocellular carcinoma and angiosarcoma of the liver, in a vinyl chloride-exposed worker without cirrhosis and any known risk factor for chronic liver disease. Both the hepatocellular carcinoma and the surrounding normal liver showed micronucleus formation, which reflects genotoxic effect of vinyl chloride. Angiosarcoma showed a KRAS G12D point mutation, which is considered to be characteristic of vinyl chloride-induced angiosarcoma. This case supports the pathogenic role of vinyl chloride in both hepatocellular carcinoma and angiosarcoma development.
authors.affiliation: Surgical Pathology & Cytopathology Unit, Department of Medicine-DIMED, University of Padova, 35121 Padova, Italy. Electronic address: mguido@unipd.it.
authors.forename: Maria
authors.initials: M
authors.lastname: Guido
authors.affiliation: Surgical Pathology & Cytopathology Unit, Department of Medicine-DIMED, University of Padova, 35121 Padova, Italy. Electronic address: samantha.sarcognato@gmail.com.
authors.forename: Samantha
authors.initials: S
authors.lastname: Sarcognato
authors.affiliation: Institute of Legal Medicine and Toxicology, University-Hospital of Padova, 35121 Padova, Italy. Electronic address: guidopelletti@gmail.com.
authors.forename: Guido
authors.initials: G
authors.lastname: Pelletti
authors.affiliation: Surgical Pathology & Cytopathology Unit, Department of Medicine-DIMED, University of Padova, 35121 Padova, Italy. Electronic address: matteo.fassan@gmail.com.
authors.forename: Matteo
authors.initials: M
authors.lastname: Fassan
authors.affiliation: Pathology Department, Ospedale dell'Angelo, 30174 Venice, Italy. Electronic address: bruno.murer@ulss12.ve.it.
authors.forename: Bruno
authors.initials: B
authors.lastname: Murer
authors.affiliation: Institute of Legal Medicine and Toxicology, University-Hospital of Padova, 35121 Padova, Italy. Electronic address: rossella.snenghi@unipd.it.
authors.forename: Rossella
authors.initials: R
authors.lastname: Snenghi
mesh_terms: D000368:Aged; D018952:Antigens, CD34 / Q000032:analysis; D014408:Biomarkers, Tumor / Q000032:analysis / Q000235:genetics; D001706:Biopsy; D006528:Carcinoma, Hepatocellular / Q000139:chemically induced* / Q000235:genetics / Q000473:pathology / Q000601:surgery; D002471:Cell Transformation, Neoplastic / Q000139:chemically induced* / Q000235:genetics / Q000473:pathology; D004252:DNA Mutational Analysis; D006394:Hemangiosarcoma / Q000139:chemically induced* / Q000235:genetics / Q000473:pathology / Q000601:surgery; D006498:Hepatectomy; D006801:Humans; D007150:Immunohistochemistry; D008099:Liver / Q000187:drug effects* / Q000473:pathology / Q000601:surgery; D008113:Liver Neoplasms / Q000139:chemically induced* / Q000235:genetics / Q000473:pathology / Q000601:surgery; D008297:Male; D048629:Micronuclei, Chromosome-Defective / Q000139:chemically induced; D009784:Occupational Diseases / Q000139:chemically induced* / Q000235:genetics / Q000473:pathology / Q000601:surgery; D016273:Occupational Exposure / Q000009:adverse effects*; D017354:Point Mutation; D016283:Proto-Oncogene Proteins p21(ras) / Q000235:genetics; D014752:Vinyl Chloride / Q000009:adverse effects*
chemical_list: D018952:Antigens, CD34; D014408:Biomarkers, Tumor; C117307:KRAS protein, human; D016283:Proto-Oncogene Proteins p21(ras); D014752:Vinyl Chloride
keywords: Hepatocellular carcinoma; Immunohistochemistry; Liver angiosarcoma; Liver toxicity; Micronucleus; Vinyl chloride