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Hepatic angiosarcoma as a cause of acute liver failure
  1. Gurpreet Singh,
  2. Christopher Mills,
  3. Khashayar Asadi,
  4. Adam Testro
  1. Liver Transplant Unit, Austin Health, Heidelberg, Victoria, Australia
  1. Correspondence to Dr Gurpreet Singh, gurpreetsg{at}


Hepatic angiosarcoma is an extremely rare disease entity that accounts for approximately 0.1%–2% of primary liver malignancy. It is three times more common in men than women and usually affects the former in their sixth or seventh decade of life. Risk factors for the development of hepatic angiosarcoma include the use of oral contraceptives, exposure to anabolic steroids, radiation, thorium dioxide, arsenic and vinyl chloride. The prognosis of hepatic angiosarcoma is extremely poor which is attributable to early metastases to other organs, resistance to traditional chemotherapy and radiotherapy regimens and rapid progression of the tumour. Optimal management of patients is poorly demarcated due to the rarity of the tumour. We present a case series of two patients: one who passed away due to acute hepatic failure secondary to hepatic angiosarcoma and the second who underwent a liver transplantation and was subsequently diagnosed with hepatic angiosarcoma based on his explant histology.

  • liver disease
  • cirrhosis

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  • Contributors GS is responsible for writing the case report. This author also completed an extensive review of the literature. GS reported to CM and AT who were the senior clinicians involved in the case. AT: responsible for supervising the medical care of the patient quoted in the case report. CM and AT were responsible for providing the medical care and coordinating the investigations for the patient in the hospital and reviewing the patients history. They will also be following up case 2 in the outpatient setting and providing ongoing care to the patient post liver transplant. KA prepared and analysed both the liver biopsies of case 1 and the liver explant of case 2 and diagnosed both patients with hepatic angiosarcoma. He is also responsible for annotating the histology figures provided in this case report.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.