Hepatic angiosarcoma occurring 65 years after thorium dioxide (Thorostrast) exposure: imaging, surgical and histopathologic findings of a historical case

We report the CT, surgical and histopathologic findings of a rare case of Hepatic Angiosarcoma (HAS) diagnosed in a 85-year old women 65 years after Thorotrast (Th²³²) exposure for angiography. At the early arterial phase of dynamic MDCT, peripheral curvilinear and central nodular puddling of contrast produced in the 8 cm tumor. Then progressive contrast filling of the tumor was observed on the delayed scans. Associated pathognomonic signs related to previous Th²³² exposure were also found comprising diffuse intrahepatic reticular bands of calcifications, numerous calcified epigastric lymph nodes and a calcified shrunken spleen. Emergency laparotomy was performed because of associated hemoperitoneum. With a delay of 65 years after Thorotrast exposure, this historical case probably represents, to our knowledge, the most delayed presentation of Th²³² related HAS ever published.