These tumors are typically hemorrhagic multinodular tumors consisting of malignant endothelial cells that grow into the lumen of liver sinusoids and veins 1 several inciting agents have been linked including thorotrast arsenic and vinyl chloride exposure as well as anabolic steroid use 2 however the majority of patients. Vinyl chloride is used primarily to make pvc a substance used in products such as pipes. Hepatolienal damage by vinyl chloride was demonstrated in 1949 and several series of vcm related occupational hass have been reported in the following decades 4.
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