Hemangioendothelial Sarcoma of the Liver after Thorotrast Injection

An autopsy case of hemangioendothelial sarcoma of the liver which occurred 33 years after the injection of thorotrast was reported. A fifty-nine years old male with complaint of abdominal swelling and progressive jaundice died of hepatic failure and hemorrhage from gastric ulcer after 10 days of medical treatment in the Kumamoto University Hospital. Autopsy revealed hemangioendothelial sarcoma and multiple capillary hemangiomas in the liver. Histologically, a yellowish brown crystalline substance was intensively accumulated in the connective tissue in and adjacent to the thickened capsule of the liver, the lymph nodes of hepatic hilus, the spleen, the bone and the bone marrow. The material was certified as thorotrast with the Th-232 activity measurement and the autoradiographical examination. The absorbed dose of irradiation of the local liver tissue was calculated to be approximately 2,597 rads in 33 years. The relation among capillary hemangioma, hemagioendothelial sarcoma, and thorotrast was discussed.