Supplementary Material for: An autopsy of ruptured hepatic angiosarcoma treated by transcatheter arterial embolization

An 80-year-old Japanese man presented to our hospital with intra-abdominal hemorrhage due to a ruptured liver tumor. His vital signs included depressed blood pressure (80/52 mmHg), tachycardia (111 bpm), and distended abdomen. CT scan showed ascites effusion with high density and 40 mm tumors in lateral segment and 40mm tumor in anterior segment of the liver. Transcatheter arterial embolization (TAE) temporarily achieved hemostasis, but he died following re-rupture 4 days later. Based on autopsy findings, the liver tumor was diagnosed as hepatic angiosarcoma. Embolic agents used during embolization were identified within the hepatic small interlobular arteries. However, there were no findings of tumor cell necrosis or ischemic change in the angiosarcoma. In the present case, TAE alone did not induce ischemia-induced tumor necrosis, suggesting that TAE might be unsuitable to treat hepatic angiosarcoma. Treatment optimization for ruptured hepatic angiosarcoma is desired.