[Liver angiosarcoma in humans: epidemiologic considerations].

A review of the available literature on angiosarcoma of the liver in an epidemiologic perspective shows that this cancer is rare (0.5-2.5 cases every 10,000,000 persons). It escapes current mortality statistics; it presents peculiar diagnostic difficulties even when histologic material is scrutinized by panels of pathologists; it occurs in both gender at every age (also in children); estimated latency is long (10-40 years, in occupational cases) or very long (60 years and above, in non-occupational cases). Thorotrast, arsenic, and vinyl chloride monomer are frequently listed as risk factors but, along with other substances (steroids, hemochromatosis, diethylstilbestrol, phenelzine, urethane, cyclophosphamide, oral contraceptives) they contribute to explaining the occurrence of no more than 20% of the published cases. Focussing on subjects exposed to vinyl chloride monomer, the published cases were all males aged 35-75 years, with an average latency of 22 years (range 10-40), in jobs with a potential for a high, or very high exposure to VCM (mainly as autoclave cleaner) started before 1970, and limited to a small number of factories. No evidence of a relationship between environmental (non occupational) exposure to VCM and angiosarcoma of the liver emerges from the available literature. We conclude that in more than 25 years of research, apart from the case of vinyl chloride, the etiology of this type of cancer has remained unchanged and largely unknown.