What are the symptoms of occupational hepatic angiosarcoma?

The occurrence of occupational hepatic hemangioma has a relatively large impact on patients. Usually patients will show symptoms such as abdominal discomfort, poor appetite and weight loss. Some patients will also have splenomegaly or symptoms of pancytopenia.

1. More than half of the cases are unexplained hepatomegaly accompanied by some gastrointestinal symptoms, with the main symptoms being hepatomegaly, abdominal pain, abdominal discomfort, fatigue, nausea, poor appetite, weight loss, occasional vomiting and fever. The course of the disease progresses rapidly, and in the late stage there may be jaundice and ascites, and the ascites is light bloody.

2. Tumor rupture causes hemoperitoneum, which leads to symptoms and signs of acute abdomen.

3. A small number of patients may have splenomegaly, with or without pancytopenia.

4. Extrahepatic metastasis is common, mostly hematogenous dissemination, and there may be symptoms and signs of metastasis to the lungs, pancreas, spleen, kidneys, adrenal glands or bones. Lung metastasis is the most common symptom and lasts for 1 week to 6 months, and sometimes lasts for 2 years.

5. The enlarged liver has nodules on the surface. In some patients, lumps can be felt on the surface of the liver, and most of them are tender. An arterial bruit may sometimes be heard on the surface of the liver. The spleen may be enlarged. Ascites is rare but may be bloody, and the patient is often accompanied by jaundice.

6. Complications: About 25% of the disease is complicated by liver cirrhosis. Tumor rupture can cause hemoperitoneum. Hepatic angiosarcoma is prone to complications such as intra-abdominal and gastrointestinal bleeding, and congestive heart failure may occur due to the presence of shunts within the tumor. Patients with hepatic angiosarcoma often have thrombocytopenia and coagulation abnormalities due to platelet accumulation in the tumor. A large number of platelets are consumed in the tumor, which can cause disseminated intravascular coagulation with secondary fibrinolysis and microangiopathic hemolytic anemia due to the rupture of red blood cells in the tumor blood circulation.