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Paediatric hepatic angiosarcoma with consumptive hypothyroidism—an important diagnostic pitfall to avoid during evaluation of hepatic vascular tumours

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Abstract

Hepatic angiosarcoma is an extremely rare primary malignant vascular tumour in children with very poor prognosis. Radiological diagnosis of hepatic angiosarcoma is challenging due to overlapping imaging features with other benign vascular hepatic tumours, particularly infantile hepatic haemangioma. Consumptive hypothyroidism is a condition that is almost exclusively associated with infantile hepatic haemangioma and has never been reported in angiosarcoma. We present a case of hepatic angiosarcoma in a 20-month-old girl, associated with consumptive hypothyroidism and, as a result, initially misdiagnosed as infantile hepatic haemangioma. Radiologists should be aware that consumptive hypothyroidism is not a reliable feature to use in excluding paediatric hepatic angiosarcoma. Biopsy should be performed in patients older than 1 year of age or with atypical imaging features.

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Author notes

  1. Dickson Fenn and Kin Fen Kevin Fung contributed equally to this work.

Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, Kwong Wah Hospital, Kowloon Bay, Hong Kong

    Dickson Fenn & Yee-Ling Elaine Kan

  2. Department of Radiology, Hong Kong Children’s Hospital, Kowloon Bay, Hong Kong

    Kin Fen Kevin Fung

  3. Division of Paediatric Haematology and Oncology, Hong Kong Children’s Hospital, Kowloon Bay, Hong Kong

    Anthony Pak-Yin Liu

  4. Department of Pathology, Hong Kong Children’s Hospital, Kowloon Bay, Hong Kong

    Wai Fu Ng

Authors
  1. Dickson Fenn
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  2. Kin Fen Kevin Fung
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  3. Anthony Pak-Yin Liu
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  4. Wai Fu Ng
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  5. Yee-Ling Elaine Kan
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Contributions

All authors contributed to the case report conception and care of the patient. Material preparation and data collection were performed by D.F. and K.F.K.F. The first draft of the manuscript was written by D.F. and K.F.K.F. and all authors commented on subsequent versions of the manuscript. All authors read and approved the final manuscript. D.F. and K.F.K.F. contributed equally to this work.

Corresponding author

Correspondence to Kin Fen Kevin Fung.

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Ethical approval was waived by our Institutional Review Board in view of the retrospective nature of the case report and all the procedures being performed were part of the routine care.

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Both parents consented to the submission of this case report to the journal.

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Fenn, D., Fung, K.F.K., Liu, A.PY. et al. Paediatric hepatic angiosarcoma with consumptive hypothyroidism—an important diagnostic pitfall to avoid during evaluation of hepatic vascular tumours. Pediatr Radiol (2024). https://doi.org/10.1007/s00247-024-05915-7

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  • DOI: https://doi.org/10.1007/s00247-024-05915-7

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