Introduction Rare malignant and very aggressive tumor that derives from endothelium of blood vessels Epidemiology demographics male>female elderly location osseous involvement in <10% 60% long bone with osseous involvement risk factors chronic vascular stasis trauma Prognosis poor high local failure rate and amputation is often required propensity for lymphatic spread metastases to lung is common Symptoms Symptoms pain symptoms often insidious Physical exam hallmarked with overlying skin changes Imaging Radiograph may see 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 Ibank Location Clinical Xray CT B. Scan MRI MRI Histo(1) Case A leg Case B pelvis (1) - histology does not always correspond to case
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? Review Topic QID: 71 FIGURES: A B C 1 Epithelioid sarcoma 19% (354/1854) 2 Chondrosarcoma 4% (73/1854) 3 Angiosarcoma 70% (1294/1854) 4 Osteosarcoma 1% (18/1854) 5 Synovial sarcoma 6% (105/1854) ML 3 Select Answer to see Preferred Response PREFERRED RESPONSE 3