summary Angiosarcomas are malignant, aggressive tumors that derive from the endothelium of blood vessels. The condition is typically seen in elderly patients who present with regional pain and overlying skin changes. Diagnosis is made with a biopsy showing malignant cells associated with vascular structures. Treatment is usually wide surgical resection with radiation. Epidemiology Demographics male > female elderly Anatomic location osseous involvement in <10% 60% long bone with osseous involvement Risk factors chronic vascular stasis trauma Symptoms Symptoms pain symptoms often insidious Physical exam hallmarked with overlying skin changes Imaging Radiograph may see the invasion of bone MRI study of choice to evaluate soft tissue mass Studies Histology vascular channels variable degree of anaplasia malignant cells associated with vascular structures Treatment Operative wide surgical resection indications treatment of choice relatively insensitive to chemotherapy and radiation amputation indications to achieve local control of disease very aggressive tumor Prognosis Poor prognosis high local failure rate and amputation is often required propensity for lymphatic spread metastases to lung is common
QUESTIONS 1 of 1 1 Previous Next (OBQ05.34) A 34-year-old male with an eleven-year history of hand exposure to polyvinyl chloride presents with hand pain, but no constitutional symptoms. Physical exam shows lesions involving the nail-folds of the thumb, long, and ring finger as well as several soft-tissue masses in the palm. A radiograph is shown in Figure A and an axial T2 MRI is shown in Figure B. Angiography shows diffuse involvement of multiple lesions in the hand. A CT scan of the chest shows metastasis to the lungs. He undergoes an open biopsy and a representative histology image is shown in Figure C. The biopsy specimen stains positive for CD31 endothelial marker. What is the most likely diagnosis? QID: 71 FIGURES: A B C Type & Select Correct Answer 1 Epithelioid sarcoma 19% (426/2260) 2 Chondrosarcoma 4% (91/2260) 3 Angiosarcoma 70% (1585/2260) 4 Osteosarcoma 1% (19/2260) 5 Synovial sarcoma 6% (125/2260) L 2 Question Complexity D Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 3 Review Tested Concept Review Full Topic