To the Editor.—
In cases of cancer due to industrial chemicals, several years of exposure may occur before any malignant neoplasm can be detected. Our previous studies1-3 of patients exposed to solvent vapors indicated damage to the liver and pancreas before a definite increased rate of malignancy was noticed. Recently, increase of angiosarcoma of the liver has been reported among workers in polyvinyl chloride plants, usually after years of exposure.We now have a patient, a 30-yearold man, who has worked for seven years in a polyvinyl chloride plant. For four years, he cleaned tanks used for storing vinyl chloride. He has complained lately of great fatigue. A liver and pancreas scan (Figure) shows his liver to be small, about 1,200 gm instead of the more than 1,500 gm expected for a patient of his height and weight. The inferior edge of the liver shows an irregular concave profile.
CAPURRO PU, Gray RL. Need for Research for Protective Measures Against Chronic Chemical Injury. JAMA. 1974;229(7):763-764. doi:10.1001/jama.1974.03230450013005