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Hepatic Epithelioid Angiosarcoma with Abberrant Synaptophysin and CDX2 Expression Mimicking Neuroendocrine/Metastatic Carcinoma: A Fatal Case Report

Year: 2026

Type: article

Abstract: We report a fatal case of presumed primary hepatic epithelioid angiosarcoma (PHEA) in an 82-year-old woman with back pain, abdominal distension, and hyponatremia. Imaging showed ascites and hypodense hepatic lesions. Ascitic cytology was negative. Liver biopsy showed malignant cells with positive erythroblast transformation-specific regulated gene 1 (ERG) and cluster of differentiation 31 (CD31) on immunohistochemistry. Patchy synaptophysin and caudal-type homeobox 2 positivity initially suggested a neuroendocrine tumor but proved aberrant; negative chromogranin with ERG/CD31 positivity supported PHEA. She was transitioned to hospice care due to rapid clinical decline. This case highlights the atypical presentation, diagnostic pitfalls, and aggressive clinical course of PHEA.

Source: ACG Case Reports Journal

DOI: 10.14309/crj.0000000000002389

Authors: Muhammad Usman, Muhammad Usman Shahbaz, Arsalan Ahmed, Muahammad Zawar Asif, Adnan Memon, Laiba Murtaza, Rafif Ahmed

Institutions: Arkansas Colleges of Health Education, Liaquat University of Medical & Health Sciences, King Edward Medical University, Allama Iqbal Medical College

Language: English

Topic: Vascular Tumors and Angiosarcomas

Subfield: Oncology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W7225240378

FWCI:

Cites: 9

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Related to: 10