Multiple hepatic metastases of cardiac angiosarcoma
| Autor: | Tiago Sevá-Pereira, Igor Gomes, Marcello Imbrizi, Nayana Fonseca Vaz, Larissa Bastos Eloy da Costa, Marlone Cunha-Silva, Daniel Ferraz de Campos Mazo, Cecília Amélia Fazzio Escanhoela, Mariana Sandoval Lourenço, Jazon Romilson de Souza Almeida |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
lcsh:Internal medicine Anemia medicine.medical_treatment lcsh:Medicine Autopsy Physical examination Pericardial effusion Pathology and Forensic Medicine Heart Neoplasms Internal Medicine Medicine Angiosarcoma Embolization Neoplasm Metastasis lcsh:RC31-1245 medicine.diagnostic_test business.industry lcsh:R Sarcoma medicine.disease Article / Autopsy Case Report Radiology Liver function Differential diagnosis business |
| Zdroj: | Autopsy and Case Reports, Vol 8, Iss 4 (2018) Autopsy & Case Reports |
| ISSN: | 2236-1960 |
| Popis: | The differential diagnosis of hepatic focal lesions is challenging because the etiology can be inflammatory, infectious, and even neoplastic. A rare cause of metastatic liver nodules is cardiac angiosarcoma. We report a case of this tumor, which was diagnosed only after autopsy. A 26-year-old Caucasian man was admitted for progressive dyspnea and cough over the past 3 weeks. Physical examination showed only hypophonetic heart sounds. Laboratory analysis demonstrated anemia and elevated inflammatory markers, despite normal biochemical parameters and liver function. Transthoracic echocardiography revealed massive pericardial effusion. Abdomen computed tomography (CT) showed multiple hepatic nodules, the largest of which measured 3 cm, but the percutaneous biopsy revealed only lobular necrosis and perisinusoidal fibrosis without granulomas or neoplastic cells. During hospitalization, the patient had fever and night sweats with weight loss, and empiric treatment for extrapulmonary tuberculosis associated with corticosteroids was initiated. The outpatient follow-up revealed complete improvement of the pericardial effusion, but maintenance of the liver lesions. After 2 months of hospital discharge, the patient was readmitted with hemorrhagic shock due to bleeding liver lesions, which were evidenced by CT. Embolization of the right hepatic artery was performed, but the patient soon died. The autopsy revealed a primary cardiac angiosarcoma with multiple hepatic metastases, rupture of the Glisson's capsule and laceration of the liver. The case shows how important and difficult the diagnosis of focal liver lesions is, since it may result in an unexpected fatal outcome. |
| Databáze: | OpenAIRE |
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