PMC2225468_01
Selective right hepatic arteriogram demonstrating an
extensive vascular mass right lobe liver.
No evidence of
contrast extravasations to suggest acute
hemorrhage at this time.
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fig1
At that time, an emergent mesenteric angiogram was obtained demonstrating a multicentric pathological vascular mass involving the right hepatic lobe (as in Figure 1).
Intraoperative
color photograph demonstrating the lobulated
blood filled cystic mass consistent with hepatic angiosarcoma.
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fig2
The patient subsequently underwent an open surgical biopsy the next morning (see Figure 2).
CT scan
abdomen with contrast demonstrated highly vascular
tumor with heterogeneous uptake pattern consistent
with hepatic angiosarcoma.
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fig3
Ultrasonography, computed tomography, and magnectic resonance imaging confirmed the findings of a hepatic neoplasm involving a significant portion of the right hepatic lobe (see Figure 3).
Right
hepatic angiogram following chemoembolization of the
hepatic angiosarcoma demonstrating the "snow storm"
appearance consistent with diffuse uptake and entrapment
of the ethiodol within the tumor.
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fig4
Successful embolization was noted fluoroscopically with diffuse uptake of the ethiodol solution within the tumor resulting in a "snow storm" uptake pattern (see Figure 4).
Three month
followup CT scan abdomen with contrast demonstrating
no enhancing tumor remaining following TACE. Extensive necrosis and deposition of ethiodol trapped
within tumor.
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fig5
No further TACE procedures were performed during this time interval and his followup CT imaging at three months demonstrated no residual or new enhancing tumor, diffuse necrosis of the previous tumor bed, and ethiodol scattered throughout the tumor masses (Figure 5).