Arsenic, vinyl chloride, viral hepatitis, and hepatic angiosarcoma: A hospital-based study and review of literature in Taiwan

BMC Gastroenterology

How-Ran Guo¹  Jyh-Seng Wang³  Shoa-Lin Lin⁴  Hong-Tai Chang²  Shue-Ren Wann²  Neng-Chyan Huang⁵ 

[1] Sustainable Environment Research Center, National Cheng Kung University, 500 An-Ming Road Section 3, Tainan 70955, Taiwan;National Yang-Ming University, School of Medicine, 155 Linong Street Section.2, Taipei 112, Taiwan;Department of Pathology, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Road, Kaohsiung 81362, Taiwan;Intensive Care Unit, Department of Internal Medicine, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Road, Kaohsiung 81362, Taiwan;Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, 138 Sheng-Li Road, Tainan 70428, Taiwan

关键词: viral hepatitis;    arsenic;    vinyl chloride;    hepatic angiosracoma;   

Others  :  1113170
DOI  :  10.1186/1471-230X-11-142

 received in 2011-05-24, accepted in 2011-12-26,  发布年份 2011

【 摘 要 】

Background

Hepatic angiosarcoma (HAS) is a rare type of liver cancer that is often fatal, and arsenic and vinyl chloride monomer (VCM) are two major causal agents. Whereas Taiwan is an endemic area of liver cancer, epidemiologic data on HAS are limited. We reviewed the cases observed at a teaching hospital to evaluate the roles of VCM, arsenic, and viral hepatitis in the occurrence of HAS.

Methods

We reviewed the medical records of patients with pathological proof of HAS from January 2000 to August 2010 at a teaching hospital which is adjacent to the major VCM processing area in Taiwan and nearby an endemic area of arsenic exposure from drinking water. We also conducted a literature review and included all patients of HAS reported in Taiwan.

Results

Six male and three female cases aged from 56 to 83 years (64.6 ± 8.2 years) were identified at the hospital. The differences in clinical features between men and women were not statistically significant. None of them had exposure to VCM or arsenic in drinking water. Two had evidence of hepatitis C infection, but none had evidence of hepatitis B infection. Five male and four female cases aged 30 to 82 years (58.6 ± 15.5 years) were identified in the literature, including two with arsenic exposure and one with chronic hepatitis B infection.

Conclusions

HAS is rare in Taiwan, and we found no evidence supporting a major role of VCM, arsenic in drinking water, or viral hepatitis in its occurrence.

【 授权许可】

   
2011 Huang et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]Locker GY, Doroshow JH, Zwelling LA, Chabner BA: The clinical features of hepatic angiosarcoma: A report of four cases and a review of the English literature. Medicine (Baltimore) 1979, 58:48-64.
• [2]Falk H, Herbert JT, Edmonds L, Heath CW Jr, Thomas LB, Popper H: Review of four cases of childhood hepatic angiosarcoma--elevated environmental arsenic exposure in one case. Cancer 1981, 47:382-391.
• [3]Ho S-Y, Tsai C-C, Tsai Y-C, Guo H-R: Hepatic angiosarcoma presenting as hepatic rupture in a patient with long-term ingestion of arsenic. J Formos Med Assoc 2004, 103:374-379.
• [4]Matsumoto M, Tamura M, Komiya T, Aridome G, Narita R, Hisaoka M, Ohtsuki M, Otsuji Y: Hepatic angiosarcoma: a rare liver tumor in a hemodialysis patient. Clin Nephrol 2009, 71:590-592.
• [5]Neshiwat LF, Friedland ML, Schorr-Lesnick B, Feldman S, Glucksman WJ, Russo RD Jr: Hepatic angiosarcoma. Am J Med 1992, 93:219-222.
• [6]Weinman MD, Chopra S: Tumors of the liver, other than primary hepatocellular carcinoma. Gastroenterol Clin North Am 1987, 16:627-650.
• [7]LaDou J: Liver cancer: Hepatic angiosarcoma. In Current Occupational & Environmental Medicine. 4th edition. Edited by LaDou J. New York: McGraw-Hill Medical; 2007:251-253.
• [8]Regelson W, Kim U, Ospina J, Holland JF: Hemangioendothelial sarcoma of liver from chronic arsenic intoxication by Fowler's solution. Cancer 1968, 21:514-522.
• [9]Lander JJ, Stanley RJ, Sumner HW, Boswell DC, Aach RD: Angiosarcoma of the liver associated with Fowler's solution (potassium arsenite). Gastroenterology 1975, 68:1582-1586.
• [10]Chen C-J, Chuang Y-C, You S-L, Lin T-M, Wu H-Y: A retrospective study on alignant neoplasms of bladder, lung and liver in blackfoot disease endemic area in Taiwan. Br J Cancer 1986, 53:399-405.
• [11]Harrison JR, Faust TW, Blackstone MO: Hepatic angiosarcoma: An unusual cause of congestive heart failure. South Med J 2001, 94:336-338.
• [12]Weng Y-J, Chao Y, Wang S-S, Chiang J-H, Tsay S-H, Chen C-C, Chau G-Y, Lui W-Y, Lee S-D: Hepatic angiosarcoma: Report of a case. Gastroenterol J Taiwan 1995, 12:208-215.
• [13]Tsai M-H, Chien R-N, Hsieh S-Y, Hung C-F, Chen T-C, Sheen I-S: Primary hepatic angiosarcoma: Report of a case involving environmental arsenic exposure. Changgeng Yi Xue Za Zhi 1998, 21:469-474.
• [14]Tsai C-C, Hsieh J-F, Han S-J, Mo L-Ray: Hemoperitoneum secondary to biopsy of the hepatic angiosarcoma. Chin J Radiol 1999, 24:37-40.
• [15]Liang W-B, Wang T-E, Lin S-C, Shin S-C, Kao C-R, Chou S-Y, Chang K-M: Primary angiosarcoma of the liver--a case report. J Intern Med Taiwan 2003, 14:290-294.
• [16]Tsai C-C, Cheng K-S, Lai H-C, Yu C-J, Hsu C-H: Ruptured angiosarcoma of the liver treated by emergency TAE--case report. In China Med Univ Reposit. Taichung: China Medical University; 2007.
• [17]Hsiao V-C: Hepatic angiosarcoma. Clin Forum Inst Hepato-Gastroenterol Yuan's General Hosp Taiwan 2008, l9:1-3.
• [18]Hsu W-H: Angiosarcoma of liver: Report of a case with literature review. In Proceedings of the 67th Annual Meeting of Taiwan Surgical Association. Kaohsiung. Taipei: Taiwan Surgical Association; 2008.
• [19]Cheng S-P, Jeng K-S: Hepatic angiosarcoma: Report of a case. Formos J Surg 2003, 36:179-183.
• [20]Alrenga DP: Primary angiosarcoma of the liver. Int Surg 1975, 60:198-203.
• [21]Ishak KG: Mesenchymal tumor of the liver. In Hepatocellular carcinoma. Edited by Okuda K, Peters RL. New York: Wiley; 1976:247-308.
• [22]Buetow PC, Buck JL, Ros PR, Goodman ZD: Malignant vascular tumors of the liver: Radiologic-pathologic correlation. Radiographics 1994, 14:153-166.
• [23]Vianna NJ, Brady JA, Cardamone AT: Epidemiology of angiosarcoma of liver in New York State. N Y State J Med 1981, 81:895-899.
• [24]Guo H-R: The lack of a specific association between arsenic in drinking water and hepatocellular carcinoma. J Hepatol 2003, 39:383-388.
• [25]Wang T-H, Pan Z-G, Ren Z-G: Rare primary liver malignant tumor. Fudan Univ J Med Sci 2009, 36:221-224.
• [26]Deng X, Hou Y-Y, Chen Y, Chou J, Tan Y-S, Su Jie AK-S: Hepatic primary malignant vascular tumor: Clinical and pathological analysis. Chin J Clin Exp Pathol 2006, 22:141-145.
• [27]Wong R-H, Chen P-C, Wang J-D, Du C-L, Cheng T-J: Interaction of vinyl chloride monomer exposure and hepatitis B viral infection on liver cancer. J Occup Environ Med 2003, 45:379-383.
• [28]Chen D-S, Sung J-L, Lai M-Y: A seroepidemiologic study of hepatitis B virus infection in Taiwan. J Formos Med Assoc 1978, 77:908-918.
• [29]Sung J-L, Chen D-S, Lai M-Y, Yu J-Y, Wang T-H, Wang C-Y, Lee C-Y, Chen S-H, Ko T-M: Epidemiological study on hepatitis B virus infection in Taiwan. Chinese J Gastroenterol 1984, 1:1-9.
• [30]Chen D-S: Hepatitis B virus infection, its sequelae, and prevention in Taiwan. In Neoplasms of the Liver. Edited by Okuda K, Ishak KG. Tokyo: Springer-Verlag; 1987:71-80.
• [31]Perico N, Cattaneo D, Bikbov B, Remuzzi G: Hepatitis C infection and chronic renal diseases. Clin J Am Soc Nephrol 2009, 4:207-220.
• [32]Chen C-H, Yang P-M, Huang G-T, Lee H-S, Sung J-L, Sheu J-C: Estimation of seroprevalence of hepatitis B virus and hepatitis C virus in Taiwan from a large-scale survey of free hepatitis screening participants. J Formos Med Assoc 2007, 106:148-155.
• [33]Mansell CJ, Locarnini SA: Epidemiology of hepatitis C in the East. Semin Liver Dis 1995, 15:15-32.
• [34]Lu S-N, Chue P-Y, Chen H-C, Wu M-H, Chen I-L, Huang J-F, Wang J-H, Peng C-F, Shih C-H, You S-L, Lu C-F, Chen C-J, Chang W-Y: Different viral aetiology of hepatocellular carcinoma between two hepatitis B and C endemic townships in Taiwan. J Gastroenterol Hepatol 1997, 12:547-550.
• [35]Yang J-F, Lin C-I, Huang J-F, Dai C-Y, Lin W-Y, Ho C-K, Hsieh M-Y, Lee L-P, Ho N-J, Lin Z-Y, Chen S-C, Hsieh M-Y, Wang L-Y, Yu M-L, Chuang W-L, Chang W-Y: Viral hepatitis infections in southern Taiwan: A multicenter community-based study. Kaohsiung J Med Sci 2010, 26:461-469.
• [36]Rahnavardi M, Hosseini Moghaddam SM, Alavian SM: Hepatitis C in hemodialysis patients: current global magnitude, natural history, diagnostic difficulties, and preventive measures. Am J Nephrol 2008, 28:628-640.
• [37]Huang C-C: Dialysis therapy in Taiwan: 1995 national surveillance report. J Nephrol ROC 1995, 9:71-83.
• [38]Koyama T, Fletcher JG, Johnson CD, Kuo MS, Notohara K, Burgart LJ: Primary hepatic angiosarcoma: Findings at CT and MR imaging. Radiology 2002, 222:667-673.