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Medicine (MD/DO)
USMLE Step 2
Hepatic Disorders
Hepatic Angiosarcoma

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Hepatic Angiosarcoma

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Hepatic Angiosarcoma

Liver Angel-shark-comb
Malignant Sarcoma
Malignant-man Shark-comb

Hepatic angiosarcoma is an aggressive malignant endothelial cell tumor of the liver.

Tumor of Vascular or Lymphatic Endothelium
Tumor-guy inside Inner-layer

Hepatic angiosarcoma is a mesenchymal tumor that originates from an endothelial cell.

Abdominal CT Scan
Abdomen Cat-scanner

CT Scan abdomen is the best initial imaging to diagnose hepatic angiosarcoma. It is seen as a hypoattenuating mass, but some can be present as hyperattenuating displaying hemorrhage on CT.


Arsenic is one of the two primary causal agents of hepatic angiosarcoma. Exposures can be from drinking water that contains a high level of arsenic, arsenic pesticides in vineyard workers, and Fowler's solution.

Vinyl Chloride
PVC Pipe

Highly reactive epoxide chloroethylene oxide generated during the reaction of vinyl chloride on the production of polyvinyl chloride can cause hepatorenal damage and TP53 mutations. These mutations increase the risk of hepatic angiosarcoma.

Thorium Dioxide (Thorotrast)
Thor with Carbonated-soda

Thorium Dioxide (Thorotrast) can cause KRAS-2 mutation, which contributes to malignancy in the liver.

Anabolic Steroid Use

Long-term anabolic steroid injection use can lead to hepatic angiosarcoma. Some athletes use these steroids to raise strength and muscle mass.

Radon Exposure
Exposed to Radiation

Radon exposure can damage the p53 tumor suppressor gene, which is believed to lead to liver carcinogenesis.

Poor Prognosis

Hepatic angiosarcoma has a poor prognosis due to its resistance to chemotherapy and radiotherapy. Data show that median expectation of life is less than 6 months.


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