About 2–3% of soft-tissue sarcomas in adults are angiosarcomas. Primary hepatic angiosarcoma is a rare malignancy, accounting for about 1.8% of all primary hepatic tumors and fewer than 5% of angiosarcomas [6, 7]. The peak age at onset is 60–70 years old, with a male-to-female predominance as high as 3:1. Although the main cause of hepatic angiosarcoma is exposure to environmental carcinogens, causes remain unknown in many patients [3, 4, 8]. Its symptoms are nonspecific and can include abdominal pain, weakness, fatigue, weight loss, anorexia, and abdominal enlargement. There is no relationship between hepatic angiosarcoma and portal hypertension. In the patient 1, however, the patient presented with esophageal varices. There are some case reports of hepatic angiosarcoma had associated with idiopathic portal hypertension, but the frequency is not high. The relationship is not clear. Diffuse hepatic angiosarcomas are especially difficult to diagnose by imaging modalities, although a blocky contrast effect of the whole liver in enhanced CT may be an indicator. These findings may suggest angiosarcomas, but they look very much alike hyperplastic nodules in liver cirrhosis. FDG-PET in one patient showed extensive diffuse abdominal accumulation throughout the whole liver, suggesting a malignant tumor [9, 10]. Histopathologically, these tumors are characterized by dilated sinusoids lined by hypertrophied endothelial cells with atypical and hyperchromatic nuclei. Immunohistochemistry has shown that these tumors are usually positive stains for endothelial markers, such as HHV-8, CD31, CD34, and ERG [10, 11]. About 7.7% of primary hepatic angiosarcomas are diffuse hepatic angiosarcomas [4]. Of 59,462 patients diagnosed with liver tumors from 1987 through 2003 in the UNOS database, seven (0.0117%) with diffuse hepatic angiosarcoma underwent liver transplantation and were pathologically diagnosed post-operatively. Their mean duration of survival after transplantation was 262 ± 146 days [12]. Owing to their poor prognosis and high recurrence rate, LT is contraindicated for patients with hepatic angiosarcomas, especially those with diffuse hepatic angiosarcomas [7]. In both cases, addition of chemotherapy such as IL-2 might be necessary after the established diagnoses.