This is a 73-year-old male, whose history only highlights past tuberculosis in his youth, who left him as a sequel an important fibrosis at the level of the left upper pulmonary lobe.
It suffers an accidental fall, producing a blunt wound at the right level, which blushes profusely, calling attention to the medical staff attending to the diphtheria of hemostasis.
For this reason an analytical was performed, which revealed: Hb: 10.6 g/dl; platelets: 115,000; leukocytes: 3,450; total bilirubin: 7,1 mg/dlGT: 53 FAT: 45; GOT:
After this, a study of liver disease was initiated, performing viral serology, proteinogram, autoimmunity study and determination of tumor markers, which are all negative.
Several imaging tests are also performed, showing the following data: abdominal CT: enlarged liver, with images compatible with liver metastases, some of them large, and relapsed by all liver segments.
Few cases of ascites of regeneration; cholangio-MRI: liver cirrhosis with multiple images suggestive of nodules without ruling out other etiologies such as metastatic.
Ascites; PET-CT: pathological uptake in both liver lobes with no evidence of more extrahepatic pathological uptake; abdominal ultrasound: several space-occupying hepatic lesions (LOE) with target-space.
Having established these findings, and with the suspicion of pathology compatible, it was decided to perform an ultrasound-guided FNA of these lesions, whose report ruled out: mesenchymal lineage, with cells with different nuclei angiosarcoma of the liver, positive for
Forty-eight hours after the puncture, the patient required hospitalization due to secondary hemoperitoneum, abdominal discomfort and peritonitis.
Bleeding spontaneously and does not require intervention, being discharged home several days later without further complications.
However, in the following weeks she suffers a progressive deterioration of her condition, presenting a mixed picture of liver failure, encephalopathy, and respiratory failure, which does not respond to medical treatment, and the patient dies from a final multiorgan failure.
