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THORIUM INDUCED HEPATIC HEMANGIOENDOTHELIOMA

ROENTGEN-ANGIOGRAPHIC FINDINGS IN TWO ADDITIONAL CASES WITH CLINICAL "INFORM AND CONSENT" PROBLEMS

JOSEPH L. CURRY M.D., WILLIAM G. JOHNSON M.D., DAVID H. FEINBERG M.D., and JOHN H. UPDEGROVE M.D.

1. Two additional cases of presumed, thorium-induced hemangioendothelioma of the liver are reported.

2. The angiographic pattern of large venous lakes conforms closely to the pathologic descriptions of this malignancy.

3. To our knowledge, angiography of the thorotrast (and vinyl chloride) liver, before the clinical evolution of malignancy, has not been recorded and may provide information of prognostic and therapeutic value.

4. Incidental identification of thorium deposits in the tissues of clinically healthy patients creates perplexing "inform and consent" problems. Presumably, these must be solved on an individual basis.

5. Because the use of thorotrast has been discontinued since the early 1950s, all physicians reviewing chest and abdominal roentgenograms should be aware of the characteristic appearance of human thorotrast deposits, especially in the liver, spleen and celiac lymph nodes.

6. The number of living thorotrast "carriers" and previous deaths from thorotrast related malignancy seems highly uncertain at this time.


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