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Magnetic Resonance Imaging of Uncommon Hepatic Mesenchymal Tumours: Haemangioendothelioma and Angiosarcoma

[ Vol. 15 , Issue. 4 ]

Author(s):

Andrzej Cieszanowski, Agnieszka Anysz-Grodzicka*, Joanna Podgorska, Beata Jagielska and Jakub Pałucki   Pages 362 - 368 ( 7 )

Abstract:


Background: Primary Hepatic Epithelioid Haemangioendothelioma (HEHE) and Primary Hepatic Angiosarcoma (PHA) are rare mesenchymal tumours with different malignant potential. Whereas HEHE demonstrates low to intermediate malignant potential, PHA is an aggressive malignancy with poor prognosis. The knowledge of typical imaging features of these lesions may facilitate correct diagnosis; however, the ultimate diagnosis of HEHE and PHA is based on histopathologic examination.

Discussion: The most typical findings helpful in diagnosing HEHE are: Presence of multiple, confluent nodules located at the liver periphery (in young to middle-aged woman), retraction of the liver capsule, marked hyperintensity on T2-weighted images, “target-sign” appearance, progressive centripetal contrast enhancement, and relatively high Apparent Diffusion Coefficient (ADC) values. More than ≥50% of nodules are hyper- or isointense on Hepatobiliary Phase (HBP) images.

Conclusion: The imaging features suggestive of PHA are: Occurrence of metastases (lungs, spleen) at the time of diagnosis, presence of a large dominant mass with smaller satellites, heterogeneity and areas of haemorrhage in a dominant mass, progressive contrast enhancement, slightly elevated ADC values as compared to other malignant liver tumours.

Keywords:

Liver neoplasms, epithelioid haemangioendothelioma, primary hepatic angiosarcoma, MR imaging, ADC value, hepatobiliary contrast agents, liver transplantation.

Affiliation:

1st Department of Radiology, Maria Skłodowska-Curie Memorial Cancer Centre, Institute of Oncology, Ul. Roentgena 5, 02-781 Warszawa, 1st Department of Radiology, Maria Skłodowska-Curie Memorial Cancer Centre, Institute of Oncology, Ul. Roentgena 5, 02-781 Warszawa, 2nd Department of Clinical Radiology, Medical University of Warsaw, Ul. Banacha 1a, 02-097 Warszawa, Department of Oncological Diagnosis and Cardio-Oncology, Maria Skłodowska-Curie Memorial Cancer Centre, Institute of Oncology, Ul. Roentgena 5, 02-781 Warszawa, 1st Department of Radiology, Maria Skłodowska-Curie Memorial Cancer Centre, Institute of Oncology, Ul. Roentgena 5, 02-781 Warszawa

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