Benign and Malignant Vascular Tumors of the Liver in Adults

ABSTRACT

Vascular tumors of the liver in adult patients include cavernous hemangioma, a common benign tumor; epithelioid hemangioendothelioma, a rare, usually low-grade malignant tumor; and angiosarcoma, a rare and very aggressive tumor. All these primary mesenchymal tumors develop on a normal liver and may also affect other organs. Their pathogenesis remains largely unknown. Hepatic tumors are increasingly detected incidentally due to widespread use of modern abdominal imaging techniques. Therefore, reliable noninvasive characterization and differentiation of such liver tumors is of major importance for clinical practice. Hemangioma follows a benign course, and a nonoperative approach for the majority of these lesions is recommended. A definitive diagnosis of epithelioid hemangioendothelioma and angiosarcoma requires histopathologic examination. Liver transplantation at an early stage has greatly improved the prognosis of epithelioid hemangioendothelioma. The prognosis of angiosarcoma remains dismal. Designing a worldwide database that contains all data about patients with these rare diseases is recommended.

KEYWORDS

Hemangioma - epithelioid hemangioendothelioma - angiosarcoma - hepatic vascular tumors

REFERENCES

• 1 Zhang W J, Ye L Y, Wu L Q et al.. Morphologic, phenotypic and functional characteristics of endothelial cells derived from human hepatic cavernous hemangioma.  J Vasc Res. 2006;  43 522-532
• 2 Hu D, Ran Y L, Zhong X et al.. Overexpressed Derlin-1 inhibits ER expansion in the endothelial cells derived from human hepatic cavernous hemangioma.  J Biochem Mol Biol. 2006;  39 677-685
• 3 Kitajima S, Liu E, Morimoto M et al.. Transgenic rabbits with increased VEGF expression develop hemangiomas in the liver: a new model for Kasabach-Merritt syndrome.  Lab Invest. 2005;  85 1517-1527
• 4 Giannitrapani L, Soresi M, La Spada E et al.. Sex hormones and risk of liver tumor.  Ann N Y Acad Sci. 2006;  1089 228-236
• 5 Ozakyol A, Kebapci M. Enhanced growth of hepatic hemangiomatosis in two adults after postmenopausal estrogen replacement therapy.  Tohoku J Exp Med. 2006;  210 257-261
• 6 Shimizu M, Miura J, Itoh H, Saitoh Y. Hepatic giant cavernous hemangioma with microangiopathic hemolytic anemia and consumption coagulopathy.  Am J Gastroenterol. 1990;  85 1411-1413
• 7 Goodman Z D, Terraciano L M. Tumours and tumour-like lesions of the liver. In: Burt AD, Portmann BC, Ferrell LD Mac Sween's Pathology of the Liver. 5th ed. Oxford; Churchill Livingstone 2007: 761-814
• 8 Lehmann F S, Beglinger C, Schnabel K, Terracciano L. Progressive development of diffuse liver hemangiomatosis.  J Hepatol. 1999;  30 951-954
• 9 Kim G E, Thung S N, Tsui W M, Ferrell L D. Hepatic cavernous hemangioma: under recognized associated histologic features.  Liver Int. 2006;  26 334-338
• 10 Bree R L, Schwab R E, Glazer G M, Fink-Bennett D. The varied appearances of hepatic cavernous hemangiomas with sonography, computed tomography, magnetic resonance imaging and scintigraphy.  Radiographics. 1987;  7 1153-1175
• 11 Vilgrain V. Tumeurs bénignes du foie. In: Vilgrain V, Menu Y Imagerie du Foie, des Voies Biliaires, du Pancréas et de la Rate. Paris; Médecine-France Flammarion 2002: 13-42
• 12 Dietrich C F, Mertens J C, Braden B et al.. Contrast-enhanced ultrasound of histologically proven liver hemangiomas.  Hepatology. 2007;  45 1139-1145
• 13 Lee J Y, Choi B I, Han J K, Kim A Y, Shin S H, Moon S G. Improved sonographic imaging of hepatic hemangioma with contrast-enhanced coded harmonic angiography: comparison with MR imaging.  Ultrasound Med Biol. 2002;  28 287-295
• 14 Brannigan M, Burns P N, Wilson S R. Blood flow patterns in focal liver lesions at microbubble-enhanced US.  Radiographics. 2004;  24 921-935
• 15 Fergusson J, Tait N. Resection for hepatic hemangiomas.  J Gastroenterol Hepatol. 2007;  22 1705
• 16 Erdogan D, Busch O R, van Delden O M et al.. Management of liver hemangiomas according to size and symptoms.  J Gastroenterol Hepatol. 2007;  22 1953-1958
• 17 Lerner S M, Hiatt J R, Salamandra J et al.. Giant cavernous liver hemangiomas: effect of operative approach on outcome.  Arch Surg. 2004;  139 818-821
• 18 Hinshaw J L, Laeseke P J, Weber S M, Lee Jr F T. Multiple-electrode radiofrequency ablation of symptomatic hepatic cavernous hemangioma.  AJR Am J Roentgenol. 2007;  189 146-149
• 19 Fan R F, Chai F L, He G X et al.. Laparoscopic radiofrequency ablation of hepatic cavernous hemangioma. A preliminary experience with 27 patients.  Surg Endosc. 2006;  20 281-285
• 20 Zeng Q, Li Y, Chen Y et al.. Gigantic cavernous hemangioma of the liver treated by intra-arterial embolization with pingyangmycin-lipiodol emulsion: a multi-center study.  Cardiovasc Intervent Radiol. 2004;  27 481-485
• 21 Longeville J H, de la Hall P, Dolan P et al.. Treatment of a giant haemangioma of the liver with Kasabach-Merritt syndrome by orthotopic liver transplant a case report.  HPB Surg. 1997;  10 159-162
• 22 Aucejo F N, Ortiz W A, Kelly D et al.. Expanding the donor pool: safe transplantation of a cadaveric liver allograft with a 10 cm cavernous hemangioma: a case report.  Liver Transpl. 2006;  12 687-689
• 23 Boyd A S, Vnencak-Jones C L, Pennington B. Microsatellite stable genome in an epithelioid hemangioendothelioma: An example of a microsatellite stable tumor.  J Am Acad Dermatol. 2008;  58 519-521
• 24 Ishak K G, Sesterhenn I A, Goodman Z D, Rabin L, Stromeyer F W. Epithelioid hemangioendothelioma of the liver: a clinicopathologic and follow-up study of 32 cases.  Hum Pathol. 1984;  15 839-852
• 25 Mehrabi A, Kashfi A, Fonouni H et al.. Primary malignant hepatic epithelioid hemangio-endothelioma: a comprehensive review of the literature with emphasis on the surgical therapy.  Cancer. 2006;  107 2108-2121
• 26 Fujii T, Zen Y, Sato Y et al.. Podoplanin is a useful diagnostic marker for epithelioid hemangioendothelioma of the liver.  Mod Pathol. 2008;  21 125-130
• 27 Lyburn I D, Torreggiani W C, Harris A C et al.. Hepatic epithelioid hemangioendothelioma: sonographic CT and MR imaging appearances.  AJR Am J Roentgenol. 2003;  180 1359-1364
• 28 Oe A, Habu D, Kawabe J et al.. A case of diffuse hepatic angiosarcoma diagnosed by FDG-PET.  Ann Nucl Med. 2005;  19 519-521
• 29 Lerut J P, Orlando G, Adam R et al.. The place of liver transplantation in the treatment of hepatic epitheloid hemangioendothelioma: report of the European liver transplant registry.  Ann Surg. 2007;  246 949-957
• 30 Zafrani E S. Update on vascular tumours of the liver.  J Hepatol. 1989;  8 125-130
• 31 Lincoln D T, Singal P K, Al-Banaw A. Growth hormone in vascular pathology: neovascularization and expression of receptors is associated with cellular proliferation.  Anticancer Res. 2007;  27 4201-4218
• 32 Tate G, Suzuki T, Mitsuya T. Mutation of the PTEN gene in a human hepatic angiosarcoma.  Cancer Genet Cytogenet. 2007;  178 160-162
• 33 van Kampen R J, Erdkamp F L, Peters F P. Thorium dioxide-related haemangiosarcoma of the liver.  Neth J Med. 2007;  65 279-282
• 34 Dogliotti E. Molecular mechanisms of carcinogenesis by vinyl chloride.  Ann Ist Super Sanita. 2006;  42 163-169
• 35 Locker G Y, Doroshow J H, Zwelling L A, Chabner B A. The clinical features of hepatic angiosarcoma: a report of four cases and a review of the English literature.  Medicine (Baltimore). 1979;  58 48-64
• 36 Buetow P C, Buck J L, Ros P R, Goodman Z D. Malignant vascular tumors of the liver: radiologic-pathologic correlation.  Radiographics. 1994;  14 153-156
• 37 Peterson M S, Baron R L, Rankin S C. HA findings on multiphasic contrast-enhanced helical CT do not mimic hepatic hemangioma.  AJR Am J Roentgenol. 2000;  175 165-170
• 38 Maeda T, Tateishi U, Hasegawa T et al.. Primary hepatic angiosarcoma on coregistered FDG PET and CT images.  AJR Am J Roentgenol. 2007;  188 1615-1617
• 39 Weitz J, Klimstra D S, Cymes K et al.. Management of primary liver sarcomas.  Cancer. 2007;  109 1391-1396
• 40 Maluf D, Cotterell A, Clark B et al.. Hepatic angiosarcoma and liver transplantation: case report and literature review.  Transplant Proc. 2005;  37 2195-2199
• 41 Budd G T. Management of angiosarcoma.  Curr Oncol Rep. 2002;  4 515-519
• 42 Ioachim H L, Adsay V, Giancotti F R, Dorset B, Melamed J. Kaposi's sarcoma of internal organs.  Cancer. 1995;  75 1376-1385
• 43 Weninger W, Partanen T A, Breiteneder-Geleff S et al.. Expression of vascular endothelial growth factor and podoplanin suggests a lymphatic endothelial cell origin of Kaposi's sarcoma tumor cells.  Lab Invest. 1999;  79 243-251
• 44 Stroebel P, Mayer F, Zerban H, Bannasch P. Spongiotic pericytoma: a benign neoplasm deriving from the perisinusoidal (Ito) cells in rat liver.  Am J Pathol. 1995;  146 903-913
• 45 Kaiserling E, Müller H. Neoplasm of hepatic stellate cells (spongiotic pericytoma): a new tumor entity in human liver.  Pathol Res Pract. 2005;  201 733-743