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Updated: Jun 22 2021

Angiosarcoma

3.4

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(25)

Images
https://upload.orthobullets.com/topic/8070/images/Case B - leg - clinical photo - parsons_moved.jpg
https://upload.orthobullets.com/topic/8070/images/Case B - leg - clinical photo 2 - parsons_moved.jpg
https://upload.orthobullets.com/topic/8070/images/Case D - dist tibia - CT - Parsons_moved.png
https://upload.orthobullets.com/topic/8070/images/Case A - pelvis invasion - parsons_moved.png
https://upload.orthobullets.com/topic/8070/images/Case B - leg - MRI - parsons_moved.jpg
https://upload.orthobullets.com/topic/8070/images/Histology A - parsons_moved.png
  • 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
      • exposure to polyvinyl chloride
  • 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
      • CD31 endothelial marker positive
  • 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
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