Angiosarcoma - bone
Angiosarcoma of bone is a malignant vascular tumor of bone. These are rare and account for less than 1% of malignant bone tumors. The majority of these tumors arising in bone are primary; however, a tiny percentage are either radiation-induced or associated with bone infarction
Epidemiology
Most common in young individuals. Males are more commonly affected than females.
Clinical presentation
Although there is no particular clinical presentation, the majority of the patients present with a chronic dull pain and/or tumor mass. Other presentations include
- associated neurological deficits
- pathological fractures - rare
Pathology
Location
- most common sites are short and long tubular bones of extremities
- femur - 23%
- tibia - 18%
- humerus - 13%
- pelvis - 7%
Patterns of involvement
Angiosarcomas can be unifocal or multifocal, with one study citing that up to one-thirdcan be multifocal .
Radiographic features
Plain radiograph
They are usually purely lytic, eccentric and occur in a metadiaphyseal location. They can have a very aggressive appearance, without a periosteal reaction and less soft tissue extension.
Can occur as multiple lesions in same bone.
Metastatic lesions to other skeletal sites may be seen.
Treatment and prognosis
In general very poor prognosis and depends on location and extent. Treatment options include:
- wide surgical excision
- limb-sparing surgery
- radiotherapy
Differential diagnosis
Possible differential considerations include:
- metastatic carcinoma to bone
- other malignant vascular tumors of bone -
- hemangiopericytoma of bone - not possible to differentiate radiologically
- hemangioendothelioma of bone - not possible to differentiate radiologically
See also
