GLUT1 Expression in Adult Hepatic Vascular Neoplasms

Abstract

Background: GLUT-1 is a glucose transport protein expressed in several vascular lesions, notably in cutaneous juvenile hemangioma (CJH) and hepatic infantile hemangioma (HIH), leading some to suggest that HIH is the visceral counterpart to CJH. GLUT-1 expression has recently been demonstrated in malignant vascular neoplasms involving soft tissue, suggesting that expression may not be restricted to benign vascular tumors. This study aims to further characterize a spectrum of adult hepatic vascular neoplasms for GLUT-1 expression. Design: We used immunohistochemistry in formalin fixed paraffin embedded tissue to evaluate benign vascular liver tumors (cavernous hemangiomas (CH), n=10) as well as malignant vascular liver tumors (epithelioid hemangioendotheliomas (EHE), n=8, and angiosarcomas (AS), n=4)) and the recently described small vessel hepatic hemangioma (SVH) (n=5), which is of uncertain malignant potential. Results: GLUT1 was variably expressed in 38% of hepatic EHE (3/8) and 50% of hepatic angiosarcoma cases (2/4), but in none of the cavernous hemangioma (0/10) or SVH cases (0/5). Conclusions: GLUT1 expression is common in malignant vascular tumors of the liver and should be interpreted with caution as a diagnostic marker of HIH. SVH often has an infiltrative border and may histologically mimic well-differentiated angiosarcoma and therefore, while absence of GLUT-1 staining does not exclude angiosarcoma, positive GLUT-1 staining should raise further suspicion for angiosarcoma in such cases.