Hepatic angiosarcoma presenting as acute liver failure in young adults. Report of two cases and review of literature

Background: Hepatic angiosarcoma is a rare tumor of endothelial origin that accounts for up to 2% of all primary neoplasms of the liver. It is uncommon in young adults and acute liver failure is a very unusual presentation of this disease. Case Presentation: We report the cases of two young male adults who presented with acute liver failure. One of them was diagnosed with primary hepatic angiosarcoma after transplantation based on the complete evaluation of the heaptectomy specimen; while the other was diagnosed through a liver biopsy which was done as part of the work-up for transplantation. Both patients had a rapidly worsening clinical course and died within 2 months of diagnosis. Conclusion: Hepatic angiosarcoma is a poor prognosis disease with high and early mortality. Therefore, a high level of suspicion should be present to promptly diagnose it, especially when dealing with patients with a rapidly worsening liver disease.