Supplementary Material for: Hepatic Angiosarcoma Presenting as Ascites: Case Report of A Rare Yet Lethal Disease

Angiosarcomas (AS), constituting less than 1% of all sarcomas, are rare soft tissue tumors originating from the endothelial cells. Hepatic Angiosarcoma (HAS) accounts for only 0.5% - 2% of primary hepatic malignancies. The patients often endorse non-specific symptoms like vague abdominal pain, nausea, vomiting, and jaundice. In advanced cases, ascites may be present. HAS is known to be a highly aggressive malignancy that carries a poor prognosis. Most patients succumb to death within six months of diagnosis due to liver failure or hemorrhage from spontaneous rupture of HAS. Although no effective treatment exists for HAS, a multidisciplinary approach involving gastroenterology, hemat-oncology, and surgery is required. Surgical resection is the only potentially curative option, which has been shown to be most beneficial when HAS is limited to one lobe. Hepatic artery embolization is used in the case of rupture of HAS. Chemotherapy can be used for palliative care in cases of advanced tumors. Therefore, it becomes imperative for clinicians to keep in mind the common presentation of a rare but lethal disease. Here we present one such case of rapidly progressive HAS.