Case list for Angiosarcoma
There are 3 CT cases with this diagnosis.
CT images shown are post interventional embolization for ruptured, biopsy proven primary hepatic angiosarcoma. Cirrhotic liver with large peripherally hypervascular mass in the right lobe with hypodense necrotic components. Note that tumor and right hepatic lobe are not completely avascular after embolization of the right hepatic artery and residual enhancement on equilibrium phase persists, which proves tumor blood supply through the portal vein. There are also numerous small hypervascular metastases in the left lobe, some of them with vague, but typical ring enhancement.
See pre-procedure CT of this primary angiosarcoma here.
Portal venous phase CT demonstrates biopsy proven primary angiosarcoma of the right lobe with extensive hypervascular as well as necrotic components. Note hemorrhage along the right paracolic gutter on coronal image due to rupture of a small portion of the tumor through the capsule.
Tumor was embolized, see CT appearance of embolized angiosarcoma here.
Ten months after resection of a 4 cm primary angiosarcoma of the right atrium of the heart (not shown) CT demonstrates numerous metastases in the non-cirrhotic liver and spleen. Most of the liver metastases are round, hypodense, and show strong eccentric or peripheral ringlike or discontinuous hypervascular enhancement following blood pool density. Lesions with bright dot sign or discontinuous peripheral enhancement are morphologically difficult to differentiate from hemangiomata, while ringlike enhancement is more suspicious for malignancy. Note the transient hypervascularity distal to the larger metastasis in the right lobe ("siphon" effect).
The largest metastasis in the left lobe ruptured; note hypersende perihepatic fluid. The patient expired four months later (14 months after primary diagnosis).