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Tortorelli I, Bellan E, Chiusole B, Murtas F, Ruggieri P, Pala E, Cerchiaro M, Buzzaccarini MS, Scarzello G, Krengli M, Bisinella G, Battisti S, Di Maggio A, Zagonel V, Tos APD, Sbaraglia M, Brunello A. Primary vascular tumors of bone: A comprehensive literature review on classification, diagnosis and treatment. Crit Rev Oncol Hematol 2024; 195:104268. [PMID: 38237880 DOI: 10.1016/j.critrevonc.2024.104268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 12/23/2023] [Accepted: 01/11/2024] [Indexed: 02/02/2024] Open
Abstract
Primary vascular tumors of bone are a heterogeneous group of neoplasms, ranging from benign hemangiomas to frankly malignant epithelioid hemangioendotheliomas and angiosarcomas. Over the years, their classification has been a matter of discussion, due to morphologic similarities and uncertainty regarding biologic behavior. Over the past decade, with the development of next-generation sequencing, there has been a significant improvement in the molecular characterization of these lesions. The integration of their morphologic, immunohistochemical and molecular features has led to a better stratification, with important prognostic and therapeutic implications. Nevertheless, primary vascular bone tumors still represent a challenge for medical oncologists. Given their rarity and heterogeneity, in the last few years, there has been no significant progress in medical treatment options, so further research is needed. Here we present a review of the current knowledge regarding primary vascular tumors of the bone, correlating clinicopathologic features with tumor behavior and therapeutic approaches.
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Affiliation(s)
- Ilaria Tortorelli
- Oncology 1 Unit, Department of Oncology, Istituto Oncologico Veneto IOV - IRCCS, Via Gattamelata 64, 35128 Padua, Italy; Department of Surgery, Oncology and Gastroenterology (DISCOG), University of Padua, Via Nicolò Giustiniani 2, 35128 Padua, Italy
| | - Elena Bellan
- Department of Pathology, Azienda Ospedale Università Padova, Via Gabelli 61, 35121 Padua, Italy
| | - Benedetta Chiusole
- Oncology 1 Unit, Department of Oncology, Istituto Oncologico Veneto IOV - IRCCS, Via Gattamelata 64, 35128 Padua, Italy
| | - Fabio Murtas
- Oncology 1 Unit, Department of Oncology, Istituto Oncologico Veneto IOV - IRCCS, Via Gattamelata 64, 35128 Padua, Italy; Department of Surgery, Oncology and Gastroenterology (DISCOG), University of Padua, Via Nicolò Giustiniani 2, 35128 Padua, Italy
| | - Pietro Ruggieri
- Department of Orthopedics and Orthopedic Oncology, University of Padua, Via Nicolò Giustiniani 1, 35128 Padua, Italy
| | - Elisa Pala
- Department of Orthopedics and Orthopedic Oncology, University of Padua, Via Nicolò Giustiniani 1, 35128 Padua, Italy
| | - Mariachiara Cerchiaro
- Department of Orthopedics and Orthopedic Oncology, University of Padua, Via Nicolò Giustiniani 1, 35128 Padua, Italy
| | | | - Giovanni Scarzello
- Radiotherapy Unit, Istituto Oncologico Veneto IOV - IRCCS, Via Nicolò Giustiniani 2, 35128 Padua, Italy
| | - Marco Krengli
- Radiotherapy Unit, Istituto Oncologico Veneto IOV - IRCCS, Via Nicolò Giustiniani 2, 35128 Padua, Italy
| | - Gianluca Bisinella
- Division of Orthopedics and Trauma, AULSS 6 Euganea, Ospedali Riuniti Padova Sud, Via Albere 30, Monselice, Padua, Italy
| | - Sara Battisti
- Division of Orthopedics and Trauma, AULSS 6 Euganea, Ospedali Riuniti Padova Sud, Via Albere 30, Monselice, Padua, Italy
| | - Antonio Di Maggio
- Oncologic Radiology Unit, Department of Radiology and Medical Physics, Istituto Oncologico Veneto IOV - IRCCS, Via Gattamelata 64, 35128 Padua, Italy
| | - Vittorina Zagonel
- Oncology 1 Unit, Department of Oncology, Istituto Oncologico Veneto IOV - IRCCS, Via Gattamelata 64, 35128 Padua, Italy
| | - Angelo Paolo Dei Tos
- Department of Pathology, Azienda Ospedale Università Padova, Via Gabelli 61, 35121 Padua, Italy; Department of Medicine, University of Padua School of Medicine, Via 8 Febbraio 2, 35122 Padua, Italy
| | - Marta Sbaraglia
- Department of Pathology, Azienda Ospedale Università Padova, Via Gabelli 61, 35121 Padua, Italy; Department of Medicine, University of Padua School of Medicine, Via 8 Febbraio 2, 35122 Padua, Italy
| | - Antonella Brunello
- Oncology 1 Unit, Department of Oncology, Istituto Oncologico Veneto IOV - IRCCS, Via Gattamelata 64, 35128 Padua, Italy.
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Rezvani A, Shahriarirad R, Erfani A, Ranjbar K. Primary malignant epithelioid hemangioendothelioma of the pleura: A review and report of a novel case. Clin Case Rep 2022; 10:e6211. [PMID: 35979384 PMCID: PMC9366930 DOI: 10.1002/ccr3.6211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 06/27/2022] [Accepted: 07/23/2022] [Indexed: 11/06/2022] Open
Abstract
Epithelioid hemangioendothelioma is considered an uncommon tumor originating from vascular tissues. Although this disease is an extremely rare malignant cancer, its pleural subtype is even less common. We discuss a 68‐year‐old man with isolated pleural epithelioid hemangioendothelioma, along with a literature review of all similar cases.
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Affiliation(s)
- Alireza Rezvani
- Bone Marrow Transplantation Center, Nemazi Hospital Shiraz University of Medical Sciences Shiraz Iran
- Thoracic and Vascular Surgery Research Center Shiraz University of Medical Science Shiraz Iran
| | - Reza Shahriarirad
- Thoracic and Vascular Surgery Research Center Shiraz University of Medical Science Shiraz Iran
- Student Research Committee Shiraz University of Medical Sciences Shiraz Iran
| | - Amirhossein Erfani
- Thoracic and Vascular Surgery Research Center Shiraz University of Medical Science Shiraz Iran
- Student Research Committee Shiraz University of Medical Sciences Shiraz Iran
| | - Keivan Ranjbar
- Thoracic and Vascular Surgery Research Center Shiraz University of Medical Science Shiraz Iran
- Student Research Committee Shiraz University of Medical Sciences Shiraz Iran
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Muthu S, Kandasamy V, Chellamuthu G, Thakur A. Custom Mega Prosthesis in a Rare case of Epithelioid Hemangioendothelioma of Proximal Tibia - A Case Report. J Orthop Case Rep 2022; 12:5-9. [PMID: 36659885 PMCID: PMC9826681 DOI: 10.13107/jocr.2022.v12.i07.2892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 04/13/2022] [Indexed: 02/08/2023] Open
Abstract
INTRODUCTION Lytic lesions of the proximal tibia include a plethora of differential diagnoses. The most common ones are the Giant cell tumor, fibrous dysplasia, adamantinoma, chondromyxoid fibroma, and osteoblastoma. The rarer ones include vascular tumors such as hemangioma and hemangioendothelioma. A systematic line of investigations is essential to pick up the right diagnosis especially in case of rarer conditions. In this background, we present a case of lytic lesion of the proximal tibia which turned out to be epitheloid hemangioendothelioma (EHE). CASE REPORT A 37-year-old female presented with pain and swelling in the left knee for 2 years. On examination, the patient had a 3 × 4 cm firm, non-tender, and well-defined swelling on the anterolateral aspect of the proximal tibia. X-ray showed a lytic lesion of the proximal tibia. Magnetic resonance imaging was suggestive of a giant cell tumor. However, the biopsy revealed a rare diagnosis of epithelioid hemangioendothelioma. CONCLUSION The patient was managed with wide excision. In a young adult, arthrodesis may not be the best option; hence, we reconstructed the joint with a custom mega prosthesis (CMP). At 3 years follow-up, our patient had no signs of recurrence. To our best knowledge, this is the first report on the use of CMP in a case of EHE.
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Affiliation(s)
- Sathish Muthu
- Department of Orthopaedics, Orthopaedic Research Group, Coimbatore, Tamil Nadu, India
- Department of Orthopaedics, Dindigul Government Medical College Hospital, Dindigul, Tamil Nadu, India
- Address of Correspondence: Dr. Girinivasan Chellamuthu, Research Associate, Orthopaedic Research Group, Church Road, Ramanathapuram, Coimbatore - 641 045, Tamil Nadu, India. E-mail:
| | - Velmurugan Kandasamy
- Department of Orthopaedics, Orthopaedic Research Group, Coimbatore, Tamil Nadu, India
- Department of Orthopaedics, Government Royapettah Hospital, Chennai, Tamil Nadu, India
| | | | - Aditya Thakur
- Department of Orthopaedics, Orthopaedic Research Group, Coimbatore, Tamil Nadu, India
- Department of Orthopaedics, Government Hospital, Rameshwaram, Tamil Nadu, India
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Gil BM, Chung MH, Lee KN, Jung JI, Yoo WJ, Kwon SS, Lee H. Multidetector CT findings of primary pleural angiosarcoma : a systematic review, an additional cases report. Cancer Imaging 2022; 22:6. [PMID: 35022068 PMCID: PMC8756718 DOI: 10.1186/s40644-021-00435-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 11/24/2021] [Indexed: 11/28/2022] Open
Abstract
Background To demonstrate and analyze the relatively common imaging findings in this rare primary pleural angiosarcoma (PPA). Case presentation Three cases of PPA, proven by video-assisted thoracic surgery biopsies are retrospectively reviewed. Patients were all male. Age ranges from 65 to 75 years old age (mean; 69). Major chief complaints were dyspnea and chest pain. One has a history of colon cancer, the other has a tuberculosis history and the other has no known history. Multidetector chest CT and PET CT were all done. Immunohistochemical studies were performed including CD31, CD34, or factor VIII-related antigen, vimentin, and cytokeratin. We also review the literatures on recently published PPA. All masses were from 1 to 10 cm. All three patients had multiple pleural based masses, which were ovoid in shape with relatively sharp margin in unilateral hemithorax. Multiple small circumscribed pleural masses are limited in the pleural space in two patients, whereas two, huge lobulated masses about up to 10 cm were present with pleural and extrapleural involvement in one patient. In two patients with pleural mass only, multiple pleural masses were only seen in parietal pleura in one patient and were in both visceral and parietal pleura in one patient. Pleural effusion were found in one side in one patient and in both sides in one patient. One angiosarcoma was arised from chronic tuberculotic pleurisy sequelae. All pleural masses are heterogenous with irregular internal low densities in all patients. Hematogenous metastases were found in liver, vertebra, rib in one patient, and were in lungs with mediastinal lymph node metastases in the other patient. Three patients survived for longer than 3months after diagnosis, but continued to deteriorate rapidly. Two patients underwent chemotherapy after surgical excision, and the other one with multiple metastases treated chemotherapy after CT-guided biopsy, but eventually all died. As a result of comparative analysis of a total of 13 patients’ images including 10 cases previously published, there was pleural effusion in all except 2 cases. Conclusions PPA were all necrotic without any vascularized enhancing nature, and manifested as unilateral circumscribed or localized pleural-based masses. Supplementary Information The online version contains supplementary material available at 10.1186/s40644-021-00435-1.
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Affiliation(s)
- Bo Mi Gil
- Department of Radiology, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 327, Sosa-ro, Bucheon-si, Gyeonggi-do, 14647, Republic of Korea
| | - Myung Hee Chung
- Department of Radiology, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 327, Sosa-ro, Bucheon-si, Gyeonggi-do, 14647, Republic of Korea.
| | - Ki-Nam Lee
- Department of Radiology, Dong-A University Hospital, Busan, Republic of Korea.,Kosin University Gospel Hospital, Busan, South Korea
| | - Jung Im Jung
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Won Jong Yoo
- Department of Radiology, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 327, Sosa-ro, Bucheon-si, Gyeonggi-do, 14647, Republic of Korea
| | - Soon Seog Kwon
- Division of Allergy and Pulmonary, Department of Internal Medicine, BUCHEON St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Heejeong Lee
- Department of Pathology, Bucheon St. Mary's Hospital, Colloge of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Gusho CA, Tepper SC, Gitelis S, Blank AT. Epithelioid hemangioendothelioma of bone: A survival analysis of 50 cases from the SEER database (1992-2016). Rare Tumors 2021; 13:20363613211005593. [PMID: 33953894 PMCID: PMC8044559 DOI: 10.1177/20363613211005593] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 03/03/2021] [Indexed: 11/15/2022] Open
Abstract
Epithelioid hemangioendothelioma (EHE) is a rare vascular tumor that may arise in bone. The purpose of this investigation was to determine the clinicopathological features and outcomes of osseous EHE in a large patient series, and to assess whether survival is impacted by demographics, tumor characteristics, or treatment factors. This was a retrospective review of the Surveillance, Epidemiology and End Results (SEER) database from 1992 to 2016. Kaplan-Meier was used to estimate overall survival (OS) and disease-specific survival (DSS). A Cox regression model was used to identify prognostic factors. Fifty patients from 1992 to 2016 with a median age of 54.5 years (IQR, 37–67) were reviewed. For location, 46% (n = 23) of tumors arose from the appendicular skeleton while 38% (n = 19) occurred within the axial skeleton (overlapping EHE: 16%, n = 8). Of the cases with recorded treatment factors, 54.8% (n = 23) had surgery, 26% (n = 13) received radiation, 22% (n = 11) were treated with chemotherapy, and 26% (n = 13) had surgery plus radiation. The 5-year OS probability was 49.2% (95% CI, 23.6–70.6), and the 5-year DSS probability was 63.9% (95% CI, 33.0–83.5). No surgery (surgery: HR, 0.262; 95% CI, 0.07–0.9); p = 0.041) and age older than 50 years (HR, 4.117; 95% CI, 1.1–15.4; p = 0.035) were negative prognostic factors of disease-specific mortality after controlling for confounding variables. There was no association between disease-specific mortality and adjuvant or multimodal therapy. The prognosis of EHE of bone is less than favorable, and the 5-year DSS probability of 64% emphasizes the intermediate grade nature of this tumor subtype. Surgical treatment, when feasible, is associated with a better prognosis.
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Affiliation(s)
- Charles A Gusho
- Department of Orthopedic Surgery, Division of Orthopedic Oncology, Rush University Medical Center; and Midwest Orthopaedics at Rush, Chicago, IL, USA
| | - Sarah C Tepper
- Department of Orthopedic Surgery, Division of Orthopedic Oncology, Rush University Medical Center; and Midwest Orthopaedics at Rush, Chicago, IL, USA
| | - Steven Gitelis
- Department of Orthopedic Surgery, Division of Orthopedic Oncology, Rush University Medical Center; and Midwest Orthopaedics at Rush, Chicago, IL, USA
| | - Alan T Blank
- Department of Orthopedic Surgery, Division of Orthopedic Oncology, Rush University Medical Center; and Midwest Orthopaedics at Rush, Chicago, IL, USA
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Hajdu SI. Pathfinders in oncology from the first clinical use of single-agent chemotherapy to the introduction of mammography. Cancer 2021; 127:12-26. [PMID: 33095913 DOI: 10.1002/cncr.33223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 09/01/2020] [Accepted: 09/03/2020] [Indexed: 01/18/2023]
Abstract
During the period from 1942 to 1962, treatment attempts with single-agent chemotherapy such as nitrogen mustard and urethan gained limited application. However, the groundbreaking success with aminopterin in the treatment of patients with pediatric acute leukemia and methotrexate in the treatment of gestational choriocarcinoma established single-agent chemotherapy as a pioneering contribution to oncology. The landmark discovery that early-stage Hodgkin disease is curable with radiation made radiotherapy into an essential specialty of oncology. Although radical surgical treatment dominated the field of surgery, the excision of localized cancers with or without adjuvant radiation emerged as new modality in therapy. Cytopathology and surgical pathology became new fields in medicine and pathologists became an integral part of the preoperative, intraoperative, and postoperative care of patients with cancer. The discovery of multiple new drugs demonstrated promising results and widened the field of oncology from the laboratory to the clinic. In the etiology of cancer, precancerous conditions were named and carcinoma of the lung was definitively linked to cigarette smoking. All things considered, the progress made between 1942 and 1962 came about through the dedicated work of many individuals. However, there were 7 distinguished pathfinders (2 pathologists, 1 pediatric pathologist-oncologist, 1 radiation therapist, 1 physician-actuary, 1 gynecologist-oncologist, and 1 chemist) who, despite their different backgrounds, interests, and sex, made groundbreaking contributions to oncology.
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Primary Vascular Tumors of Bone: A Monoinstitutional Morphologic and Molecular Analysis of 427 Cases With Emphasis on Epithelioid Variants. Am J Surg Pathol 2020; 44:1192-1203. [PMID: 32271190 DOI: 10.1097/pas.0000000000001487] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Recent molecular discoveries have refined vascular bone tumor classification. To investigate the clinical relevance of these refinements, we reviewed all cases of primary vascular bone tumors treated at our Institute. On the basis of morphology, cases were assessed immunohistochemically and molecularly. A total of 427 cases of primary vascular tumor of bone with available follow-up and histologic material were retrieved and reclassified according to the most recent diagnostic criteria as follows: 289 hemangiomas, 38 epithelioid hemangiomas, 21 epithelioid hemangioendotheliomas, 2 retiform hemangioendotheliomas, 1 intraosseous papillary intralymphatic angioendothelioma, 24 pseudomyogenic hemangioendotheliomas, and 52 angiosarcomas (of these, 45 were epithelioid angiosarcomas and 7 spindle cell secondary angiosarcoma). Both epithelioid and classic hemangiomas behave as benign tumors with excellent prognosis. The distinction between cellular and conventional type of epithelioid hemangioma was not associated with a different clinical course. Conversely, epithelioid hemangioendothelioma exhibited a more aggressive clinical behavior than hemangioma, with higher rates of multifocality and distant spread. Immunohistochemical positivity for CAMTA1 or TFE3 did not have a prognostic implication. In epithelioid hemangioendothelioma, the presence of morphologic malignant features was associated with reduced disease-free (P=0.064) and overall survival (P=0.055). Pseudomyogenic hemangioendothelioma featured local aggressiveness in 5/24 patients exhibiting a clinical behavior closer to epithelioid hemangioma than epithelioid hemangioendothelioma. Last, 32/45 patients with epithelioid angiosarcoma died of disease with a median survival time of 10 months from diagnosis. In conclusion, the integration of morphologic, immunohistochemical, and molecular features allows a better stratification of primary vascular tumors of bone with significant prognostic and therapeutic implications.
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Sedhai YR, Basnyat S, Golamari R, Koirala A, Yuan M. Primary pleural angiosarcoma: Case report and literature review. SAGE Open Med Case Rep 2020; 8:2050313X20904595. [PMID: 32095244 PMCID: PMC7011321 DOI: 10.1177/2050313x20904595] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 01/06/2020] [Indexed: 12/12/2022] Open
Abstract
Primary pleural angiosarcoma is an exceptionally rare malignancy of pleura
originating from the vascular endothelial cells. Here, we present a 70-year-old
African-American female who presented with 1-month history of dyspnea on
exertion, loss of appetite, and loss of weight along with left-sided pleuritic
chest pain. Evaluation revealed hemorrhagic pleural effusion in the left pleural
cavity. Computed tomography of the chest performed after therapeutic
thoracocentesis revealed left upper lobe lung mass along with multiple nodules
in right lung. Mass was biopsied at video-assisted thoracoscopy. Histopathology
was consistent with high-grade angiosarcoma. Endothelial origin of the tumor
cells was confirmed with positive immunohistochemical staining with CD31
antibodies. Our patient was diagnosed with primary pleural angiosarcoma
metastatic to the lung. She opted for palliative care and had a rapidly
declining clinical course and expired within 5 weeks of the diagnosis. Here, we
present a case report and review the relevant literature.
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Abstract
Two cases of angiosarcoma of the breast are presented. In spite of the often differentiated histologic pattern, this neoplasm is highly malignant and has a very poor prognosis due to its proclivity for hematogenous metastases. A short review of the recent literature corroborates this.
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Epithelioid Angiosarcoma Arising from a Huge Leiomyoma: A Case Report and a Literature Review. Case Rep Obstet Gynecol 2018; 2018:7591769. [PMID: 29967705 PMCID: PMC6008691 DOI: 10.1155/2018/7591769] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 05/03/2018] [Indexed: 01/19/2023] Open
Abstract
Uterine mesenchymal tumors other than leiomyosarcoma, carcinosarcoma, and endometrial stromal sarcomas are extremely uncommon. We describe a case of epithelioid angiosarcoma of the uterus and review previous literature on such rare tumors. A 48-year-old woman presented with a 1-year history of abdominal fullness and 10kg weight loss. Pelvic magnetic resonance imaging (MRI) revealed a huge (30×18cm) uterus accompanied by degeneration and necrosis. She underwent supracervical hysterectomy and right salpingo-oophorectomy. We postoperatively diagnosed the mass as an epithelioid angiosarcoma arising from a leiomyoma. Vasodilatation was observed within the range of 2 cm × several mm in the leiomyoma, and proliferation of atypical cells was observed covering the surface of the luminal side. The tumor showed a partly fine vascular structure and was associated with obvious nuclear atypia and mitotic figures. She received 6 courses of adjuvant chemotherapy with paclitaxel, epirubicin, and carboplatin, and there have been no signs of recurrence for 10 months.
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11
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Govoni E, Pileri S, Bazzocchi F, Severi B, Martinelli G. Postmastectomy Angiosarcoma: Ultrastructural Study of a Case. TUMORI JOURNAL 2018; 67:79-86. [PMID: 7195620 DOI: 10.1177/030089168106700115] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The ultrastructural findings of a case of Stewart-Treves syndrome are reported. The authors believe that some features, never described before, confirm the truly vascular nature of this neoplasm.
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van IJzendoorn DGP, Bovée JVMG. Vascular Tumors of Bone: The Evolvement of a Classification Based on Molecular Developments. Surg Pathol Clin 2018; 10:621-635. [PMID: 28797505 DOI: 10.1016/j.path.2017.04.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The classification of vascular tumors of bone has been under debate over time. Vascular tumors in bone are rare, display highly overlapping morphology, and, therefore, are considered difficult by pathologists. Compared with their soft tissue counterparts, they are more often multifocal and sometimes behave more aggressively. Over the past decade, with the advent of next-generation sequencing, recurrent molecular alterations have been found in some of the entities. The integration of morphology and molecular changes has led to a better characterization of these separate entities.
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Affiliation(s)
- David G P van IJzendoorn
- Department of Pathology, Leiden University Medical Center, Postzone L1-Q, Postbus 9600, Leiden 2300 RC, The Netherlands
| | - Judith V M G Bovée
- Department of Pathology, Leiden University Medical Center, Postzone L1-Q, Postbus 9600, Leiden 2300 RC, The Netherlands.
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Abstract
Vascular lesions of the breast comprise a heterogeneous group that includes a variety of benign, atypical, and malignant lesions. The presentation of these lesions ranges from those that are microscopic and discovered incidentally, to large tumors that may extensively involve the breast parenchyma and skin. In addition, some non-vascular breast lesions have features that may mimic those of vascular lesions and need to be distinguished from them in order to avoid an erroneous diagnosis. In this review, we discuss the spectrum of vascular lesions of the breast with particular emphasis on those lesions of greatest clinical importance, angiosarcoma and atypical vascular lesions. We also discuss lesions that may be mistaken for vascular lesions.
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Affiliation(s)
- Gabrielle M Baker
- (a)Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
| | - Stuart J Schnitt
- (b)Brigham and Women's Hospital, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA.
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15
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Wen DW, Tan TJ, Rasheed S. Synovial haemangioma of the knee joint: an unusual cause of knee pain in a 14-month old girl. Skeletal Radiol 2016; 45:827-31. [PMID: 26960422 DOI: 10.1007/s00256-016-2356-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 02/15/2016] [Accepted: 02/22/2016] [Indexed: 02/02/2023]
Abstract
We report a histologically proven case of synovial haemangioma of the knee in a 14-month old girl who presented to the emergency department with an acute 1-day history of refusing to weight-bear on the right leg and a preceding 3-week history of a right knee lump. Physical examination revealed a non-tender, soft lump over the lateral infrapatellar region. Radiographs revealed a poorly defined soft tissue density over the infrapatellar fat pad and a suprapatellar joint effusion. Ultrasound was used to confirm the presence of a vascular soft tissue mass compatible with a synovial haemangioma within the infrapatellar fat pad which showed both intra-articular and extra-articular extension. There was good correlation of the ultrasound findings with magnetic resonance imaging (MRI), highlighting the potential clinical utility of ultrasound as an alternative imaging modality in establishing the pre-operative diagnosis and extent of a synovial haemangioma about the knee joint.
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Affiliation(s)
- D W Wen
- Department of Diagnostic and Interventional Imaging, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore.
| | - T J Tan
- Department of Radiology, Changi General Hospital, 2 Simei Street 3, Singapore, 529889, Singapore
| | - S Rasheed
- Department of Diagnostic and Interventional Imaging, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore
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Ferreiro L, San-José E, Suárez-Antelo J, Abdulkader I, Martínez-de-Alegría A, González-Barcala FJ, Valdés L. Spontaneous bilateral haemothorax as presentation of primary pleural epithelioid haemangioendothelioma. CLINICAL RESPIRATORY JOURNAL 2015; 11:1079-1085. [PMID: 26620871 DOI: 10.1111/crj.12421] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2015] [Revised: 10/05/2015] [Accepted: 11/13/2015] [Indexed: 12/26/2022]
Abstract
Pleural epithelioid haemangioendothelioma (EHE) is a rare tumour that originates in the vascular endothelium with an intermediate degree of malignancy between haemangioma and angiosarcoma. Smoking and asbestos exposure are unproven risk factors and diagnosis is usually confirmed by thoracoscopy, since pleural fluid (PF) cytology is often not conclusive. Immunohistochemistry can also help to confirm the diagnosis. We report an 85-year-old patient with bilateral pleural EHE diagnosed by thoracoscopy, who debuted with a spontaneous bilateral haemothorax, the second described so far, and we conducted a thorough review of the literature to describe the clinical, radiological and prognostic features, as well as the PF, of this rare tumour.
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Affiliation(s)
- Lucía Ferreiro
- Department of Pulmonology, University of Santiago Hospital Complex, Santiago de Compostela, Spain
| | - Esther San-José
- Department of Clinical Analysis, University of Santiago Hospital Complex, Santiago de Compostela, Spain.,Interdisciplinary Pulmonology Research Group, Health Research Institute of Santiago (IDIS), University of Santiago Hospital Complex, Santiago de Compostela, Spain
| | - Juan Suárez-Antelo
- Department of Pulmonology, University of Santiago Hospital Complex, Santiago de Compostela, Spain
| | - Ihab Abdulkader
- Department of Pathology, University of Santiago Hospital Complex, Santiago de Compostela, Spain
| | | | - Francisco-Javier González-Barcala
- Department of Pulmonology, University of Santiago Hospital Complex, Santiago de Compostela, Spain.,Interdisciplinary Pulmonology Research Group, Health Research Institute of Santiago (IDIS), University of Santiago Hospital Complex, Santiago de Compostela, Spain
| | - Luis Valdés
- Department of Pulmonology, University of Santiago Hospital Complex, Santiago de Compostela, Spain.,Interdisciplinary Pulmonology Research Group, Health Research Institute of Santiago (IDIS), University of Santiago Hospital Complex, Santiago de Compostela, Spain
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17
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Hemangioendothelioma of the cervical spine: report of a rare case. J Orthop Sci 2015; 20:1155-9. [PMID: 25212746 DOI: 10.1007/s00776-014-0630-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Accepted: 07/18/2014] [Indexed: 10/24/2022]
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18
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Matsuda K, Yamaryo T, Akazawa Y, Kawakami K, Nakashima M. Primary pleural angiosarcoma associated with pneumoconiosis: An autopsy case. Pathol Int 2015; 65:603-7. [PMID: 26314557 DOI: 10.1111/pin.12347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 08/04/2015] [Indexed: 11/29/2022]
Abstract
We report a case of pleural angiosarcoma in an adult male patient confirmed by autopsy and possibly associated with pneumoconiosis. The lesion was characterized by thickened pleura of both lungs with nodular tumors. Histologically, the tumor was composed of spindle-to-polygonal epithelioid cells that were positive for CD31, CD34, vimentin, and cytokeratin on immunohistochemical staining but were negative for calretinin. Further examination revealed mix-dust pathological findings consistent with the existence of pneumoconiosis; dystrophic ossification, anthracosis, and fractal small dust particles were observed in the lung parenchyma and a hilar lymph node. The current case suggests that pneumoconiosis-associated pathologies may be risk factors for the development of angiosarcoma in the pleura.
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Affiliation(s)
- Katsuya Matsuda
- Department of Tumor and Diagnostic Pathology, Atomic Bomb Disease Institute, Nagasaki University Hospital, Nagasaki, Japan
| | - Takeshi Yamaryo
- Nagasaki Kawatana Medical Center, Surgery, National Hospital Organization, Nagasaki, Japan
| | - Yuko Akazawa
- Department of Tumor and Diagnostic Pathology, Atomic Bomb Disease Institute, Nagasaki University Hospital, Nagasaki, Japan.,Department of Gastroenterology and Hepatology, Nagasaki University Hospital, Nagasaki, Japan
| | - Kenji Kawakami
- Nagasaki Kawatana Medical Center, Surgery, National Hospital Organization, Nagasaki, Japan
| | - Masahiro Nakashima
- Department of Tumor and Diagnostic Pathology, Atomic Bomb Disease Institute, Nagasaki University Hospital, Nagasaki, Japan
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Doeuk C, McNamara Z, Taheri T, Batstone MD. Primary angiosarcoma of the mandible: a case report. J Oral Maxillofac Surg 2014; 72:2499.e1-7. [PMID: 25315306 DOI: 10.1016/j.joms.2014.07.035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Revised: 07/28/2014] [Accepted: 07/28/2014] [Indexed: 10/25/2022]
Abstract
Angiosarcomas are rare but aggressive vascular cancers of endothelial cell origin. Characteristically, they have a high local recurrence rate and an early metastatic potential. They rarely migrate to the skeleton, and even more unlikely, they may originate in the bones of the face. We present a rare occurrence of a primary angiosarcoma of the mandible. This case highlights the scarce literature available and difficulties in diagnosing and managing this aggressive tumor.
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Affiliation(s)
- Celine Doeuk
- Resident Medical Officer, Department of Oral and Maxillofacial Surgery, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.
| | - Zeb McNamara
- Registrar, Department of Oral and Maxillofacial Surgery, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Touraj Taheri
- Staff Specialist, Department of Anatomical Pathology, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Martin D Batstone
- Head of Department, Department of Oral and Maxillofacial Surgery, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
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20
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Hamdi S, Ghigna MR, Fadel E. Angiosarcomes intrathoraciques. ONCOLOGIE 2014. [DOI: 10.1007/s10269-014-2399-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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21
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Alexandrova E, Sergieva S, Mihaylova I, Zarkova A. Primary angiosarcoma of the breast complicated by the syndrome of disseminated intravascular coagulation (DIC): Case report and literature review. Rep Pract Oncol Radiother 2014; 19:221-5. [PMID: 24936339 PMCID: PMC4056537 DOI: 10.1016/j.rpor.2013.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Revised: 08/28/2013] [Accepted: 10/02/2013] [Indexed: 01/27/2023] Open
Abstract
Primary angiosarcoma of the breast (PAB) accounts for 0.04% of all breast malignant tumors. It affects young women usually at third or fourth decades of life. PAB clinically manifests as a painless, movable mass with sharp limits. A bluish red discoloration of the overlying skin is often observed. Enlargement of axillary lymph nodes generally does not occur. Angiosarcoma of the breast has a very poor prognosis due to the tendency to metastasize haematogenously and high frequency of local recurrence. Mastectomy and chemotherapy are preferable treatment choices. This paper presents a case of primary angiosarcoma of the breast with a syndrome of disseminated intravascular coagulation (DIC).
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22
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Surgical treatment and results of 62 patients with epithelioid hemangioendothelioma of bone. J Surg Oncol 2014; 109:791-7. [DOI: 10.1002/jso.23587] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2013] [Accepted: 02/11/2014] [Indexed: 01/16/2023]
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23
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Abstract
Hemangioendothelioma is the term used to name those vascular neoplasms that show a borderline biological behavior, intermediate between entirely benign hemangiomas and highly malignant angiosarcomas. Although originally spindle cell hemangioendothelioma was proposed as a specific clinicopathologic variant of hemangioendothelioma, currently, it is considered as an entirely benign lesion, and thus, the name spindle cell hemangioma seems to be the most accurate for this lesion. Authentic hemangioendotheliomas involving the skin and soft tissues include papillary intralymphatic angioendothelioma (also known as Dabska tumor), retiform hemangioendothelioma, kaposiform hemangioendothelioma, epithelioid hemangioendothelioma, pseudomyogenic hemangioendothelioma (also known as epithelioid sarcoma-like hemangioendothelioma), and composite hemangioendothelioma. Each of these neoplasms exhibit characteristic histopathologic features. The most characteristic finding of papillary intralymphatic hemangioendothelioma consists of papillary tufts, with a central hyaline core lined by hobnail-like endothelial cells protruding into the lumina. Retiform hemangioendothelioma is an infiltrative neoplasm composed of elongated arborizing vessels, arranged in an anastomosing pattern that resembles that of the rete testis, and lined by a single layer of hobnail-like endothelial cells that protrude within the narrow lumina. Kaposiform hemangioendothelioma is composed of several solid poorly circumscribed nodules, and each nodule is composed of a mixture of small capillaries and solid lobules of endothelial cells arranged in a glomeruloid pattern. A frequent finding consists of the presence of areas of lymphangiomatosis adjacent to the solid nodules. Epithelioid hemangioendothelioma is composed of cords, strands, and solid aggregates of round, oval, and polygonal cells, with abundant pale eosinophilic cytoplasm, vesicular nuclei, and inconspicuous nucleoli, embedded in a fibromyxoid or sclerotic stroma. Many neoplastic cells exhibit prominent cytoplasmic vacuolization as an expression of primitive vascular differentiation. Pseudomyogenic hemangioendothelioma is a poorly circumscribed, fascicular lesion with infiltrative borders composed of round or oval neoplastic cells, with vesicular nuclei and inconspicuous nucleoli, and ample homogeneous eosinophilic cytoplasm, giving them a rhabdomyoblastic appearance. Finally, composite hemangioendothelioma is the term used to name locally aggressive vascular neoplasms of low-grade malignancy showing varying combinations of benign, low-grade malignant, and high-grade malignant vascular components. From the immunohistochemical point of view, proliferating cells of all hemangioendotheliomas express a lymphatic endothelial cell immunophenotype. Most hemangioendotheliomas are low-grade vascular neoplasms, with a tendency to recur locally and a low metastatic potential, mostly to regional lymph nodes. Epithelioid hemangioendothelioma, especially large lesions and those located in deep soft tissues, seems to have a more aggressive biological behavior.
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Affiliation(s)
- Luis Requena
- Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain.
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24
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Kao YC, Chow JM, Wang KM, Fang CL, Chu JS, Chen CL. Primary pleural angiosarcoma as a mimicker of mesothelioma: a case report **VS**. Diagn Pathol 2011; 6:130. [PMID: 22208720 PMCID: PMC3260116 DOI: 10.1186/1746-1596-6-130] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2011] [Accepted: 12/30/2011] [Indexed: 11/24/2022] Open
Abstract
Primary pleural angiosarcoma is a rare and clinically aggressive tumor. Patients usually present with chest pain, dyspnea, hemoptysis and/or cough. Radiologic studies reveal diffuse pleural thickening and pleural effusion with or without mass lesion. The clinical and radiological features both resemble those of mesothelioma, and its definite diagnosis requires careful histologic examination. However, frequent epithelioid feature and immunoreactivity to cytokeratin in primary pleural angiosarcoma further complicate the pathologic diagnosis. The use of proper immunohistochemical stains is often needed to support endothelial differentiation in the tumor cells and to exclude metastatic carcinoma and mesothelioma. We report the case of a 49-year-old male patient with primary pleural angiosarcoma, who presented with initial hemothorax, followed by a rapid progress to an inoperable status.
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Affiliation(s)
- Yu-Chien Kao
- Department of Pathology, Wan Fang Hospital, Taipei Medical University, Taiwan
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25
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Kakouri E, Whelan JS, Coltart S, Smith ME, Souhami RL. Multi-focal, multi-centric angiosarcoma of bone. Sarcoma 2011; 1:183-7. [PMID: 18521223 PMCID: PMC2395360 DOI: 10.1080/13577149778290] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
A multi-focal multi-centric, malignant tumour of vascular origin arising in bone in a 55-year-old man is described. The
presenting symptoms were pain and weight loss. Radiologically, multiple lytic lesions were demonstrated in the long bones
of both legs and throughout the pelvis. Histological examination demonstrated an angiosarcoma which was predominantly
low grade in nature but with focal areas of intermediate grade. Turnout cells expressed the endothelial markers CD31,
CD34 and von Willebrand's factor. There was rapid radiological progression of disease with no response to radiotherapy.
Pain abated within a few days of institution of doxorubicin, 75 mg m-2, but the patient died of massive pulmonary
thromboembolism 14 days later, 11 months after the first symptoms.
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Affiliation(s)
- E Kakouri
- The London Soft Tissue & Bone Tumour Service The Meyerstein Institute of Oncology The Middlesex Hospital Mortimer Street London W1N 8AA UK
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Heterologous and rare homologous sarcomas of the uterine corpus: a clinicopathologic review. Adv Anat Pathol 2011; 18:60-74. [PMID: 21169739 DOI: 10.1097/pap.0b013e3182026be7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Pure sarcomas of the uterine corpus are uncommon, constituting less than 3% of all malignancies at this site, and most of them are leiomyosarcomas and endometrial stromal sarcomas. Rare histotypes of homologous sarcomas and heterologous sarcomas are occasionally encountered, and the absence of significant accumulated experience with these histotypes at this location may potentially raise diagnostic and patient management difficulties. In this article, the clinicopathologic attributes of all earlier reported sarcomas of the uterine corpus other than leiomyosarcomas and endometrial stromal sarcomas are summarized. Included are embryonal rhabdomyosarcoma, pleomorphic rhabdomyosarcoma, angiosarcoma, alveolar soft part sarcoma, malignant perivascular epithelioid cell tumors (PEComas), osteosarcoma, chondrosarcoma, liposarcomatous tumors, malignant extrarenal rhabdoid tumors, Ewing sarcoma/primitive neuroectodermal tumor, and other rare histotypes. Embryonal rhabdomyosarcoma (20%), Ewing sarcoma/primitive neuroectodermal tumor (17%), angiosarcoma (14%), and pleomorphic rhabdomyosarcoma (13%) appeared to be more common than the others, although there was no single overwhelmingly prevalent histotype in the group. A subset, including embryonal rhabdomyosarcoma, alveolar soft part sarcoma, and PEComas, peak in the premenopausal years, but most of the others were observed in postmenopausal women. Favorable outcomes have been reported for the patients diagnosed with alveolar soft part sarcoma, and the prognosis for their counterparts with PEComa remains a matter of debate. Multimodal therapeutic approaches to contemporary patients with embryonal rhabdomyosarcomas have resulted in significantly improved outcomes. Unfortunately, most of the other sarcomas have been associated with rapid tumor progression and unfavorable patient outcomes. The differential diagnosis for these sarcomas is often extensive and varies by histotype, but their accurate diagnosis fundamentally requires the careful exclusion of biphasic malignancies.
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27
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Inoue H, Miyazaki Y, Kikuchi K, Fujinami M, Yoshida N, Ide F, Sakashita H, Kusama K. Intravascular papillary endothelial hyperplasia of the oral cavity. J Oral Sci 2011; 53:475-80. [DOI: 10.2334/josnusd.53.475] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Dainese E, Pozzi B, Milani M, Rossi G, Grazia Pezzotta M, Vertemati G, Tricomi P, Sessa F. Primary pleural epithelioid angiosarcoma. A case report and review of the literature. Pathol Res Pract 2010; 206:415-9. [PMID: 20089367 DOI: 10.1016/j.prp.2009.11.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2008] [Revised: 09/14/2009] [Accepted: 11/24/2009] [Indexed: 10/19/2022]
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30
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Classification and Incidence. Acta Otolaryngol 2009. [DOI: 10.3109/00016487109121114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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31
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Fenn S, Datir A, Saifuddin A. Synovial recesses of the knee: MR imaging review of anatomical and pathological features. Skeletal Radiol 2009; 38:317-28. [PMID: 18777177 DOI: 10.1007/s00256-008-0570-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2008] [Revised: 07/15/2008] [Accepted: 07/23/2008] [Indexed: 02/02/2023]
Abstract
The knee joint is a complex anatomical structure playing host to a wide variety of pathological processes. Knowledge of the anatomy of the synovial recesses and plicae relating to the knee is important, as the appearance of pathology in these unusual locations may, even for commonly encountered conditions, lead to diagnostic uncertainty. This review article discusses the magnetic resonance imaging (MRI) anatomy of the knee joint with an emphasis on the synovial recesses and plicae. The MRI appearance of a variety of synovial and osteochondral diseases that may involve these sites is illustrated.
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Affiliation(s)
- S Fenn
- Department of Radiology, The Princess Alexandra Hospital NHS Trust, Harlow, Essex, UK
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32
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Vetter-Kauczok CS, Ströbel P, Bröcker EB, Becker JC. Kaposiform hemangioendothelioma with distant lymphangiomatosis without an association to Kasabach-Merritt-Syndrome in a female adult! Vasc Health Risk Manag 2008; 4:263-6. [PMID: 18629354 PMCID: PMC2464749 DOI: 10.2147/vhrm.2008.04.01.263] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Kaposiform hemangioendothelioma (KHE) is a locally aggressive vascular tumor which usually occurs in infants. Clinically it appears as ill-defined red to purple indurated plaque. KHE is commonly associated with Kasabach-Merritt syndrome (KMS) and lymphangiomatosis. Microscopically, the tumor is composed of infiltrating lobulated nodules with slitlike or crescentic vessels which are poorly canalized and lined by spindle shaped endothelial cells. We report a 36-year old female who developed a reddish tumor on the chest. Histological examination revealed a KHE, which was clinically not associated with thrombocytopenia or bleeding complications, but lymphangiomatosis at the right submandibular region. The association of KHE in a female adult with lymphangioma rather than KMS in this case supports the hypothesis that such an association may represent a benign subform of this disease in an adult and excision seems to be curative.
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33
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Gana R, Fatémi N, Sghiar J, Maaqili R, Bellakhdar F. Hemangioendothelioma of the skull: A case report. Radiography (Lond) 2008. [DOI: 10.1016/j.radi.2007.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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34
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Olawaiye AB, Morgan JA, Goodman A, Fuller AF, Penson RT. Epithelioid angiosarcoma of the uterus: a review of management. Arch Gynecol Obstet 2008; 278:401-4. [PMID: 18642010 DOI: 10.1007/s00404-008-0727-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2008] [Accepted: 06/30/2008] [Indexed: 11/24/2022]
Abstract
BACKGROUND Uterine epithelioid angiosarcoma is extremely rare. Evidence-based advice regarding optimal management is lacking. METHOD We report the 22nd case in the world literature and review all the cases reported in English since 1900. An attempt is made to generate information that may help in the management based on the available literature. RESULTS A 54-year-old woman was found to have an enlarged uterus on routine clinical examination. Although, she had no other symptoms, an endometrial biopsy was performed, which indicated a high-grade sarcoma. She was taken for a total abdominal hysterectomy and bilateral salpingo-oophorectomy and final histology returned a diagnosis of epithelioid angiosarcoma of the uterus. Two months later, she had tumor recurrence and was started on gemcitabine and taxotere later changed to albumin-bound paclitaxel (ABI-007, Abraxane) and bevacizumab. She was still alive with no evidence of disease at the time of this report, 12 months after diagnosis. Literature review suggests that surgical resection followed by chemotherapy is a reasonable management approach. CONCLUSION Uterine epithelioid angiosarcoma is an uncommon but very aggressive disease. Surgical resection followed by sequential chemotherapy is a reasonable management approach, and modern chemotherapy and anti-angiogenic agents may have merit.
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Affiliation(s)
- Alexander B Olawaiye
- Gynecologic Oncology Division, Department of Obstetrics, Gynecology and Reproductive Biology, Massachusetts General Hospital/Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA
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36
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Soft Tissue Tumors of the Hand. 2. Malignant. Dermatol Surg 2007. [DOI: 10.1097/00042728-200707000-00001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
Soft tissue tumors of the hand arise from skin, subcutaneous tissue, tendons, nerve, and blood vessels. Many of these lesions occur on other parts of the body; however, the hand remains a unique site because these tumors have symptoms, appearances, treatments, and prognoses that may be quite different than when on other parts of the body. Their characteristics and the severity of symptoms vary markedly depending on the exact location, size, and type of tumor-and many of these tumors can have multiple forms of presentation. Two articles are intended to provide an overview of benign (previous article) and malignant tumors (this article) of the hand. The rarer and more deleterious tumors are discussed in detail while the common tumors and epidermal lesions with which practitioners are familiar are briefly overviewed. At the completion of these review articles, participants should be able to identify and diagnose various benign and malignant hand tumors as well as understand the accepted current treatment of these growths.
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Affiliation(s)
- Joseph F Sobanko
- Department of Dermatology, Georgetown University Hospital/Washington Hospital Center, Washington, DC, USA.
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38
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SEYMOUR-JONES A. Leiomyoma of the Pharynx with Case Report. The Journal of Laryngology & Otology 2007; 73:396-8. [PMID: 14445293 DOI: 10.1017/s0022215100055468] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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40
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41
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Affiliation(s)
- E Mavis McConnell
- Liverpool Radium Institute, and the Wrexham, Powys
- Mawddach Hospitals Group
| | - Hilda R Harris
- Liverpool Radium Institute, and the Wrexham, Powys
- Mawddach Hospitals Group
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CALNAN J, COWDELL RH. Lymphangio-endothelioma of the anterior abdominal wall. Report of a case. Br J Surg 2005; 46:375-9. [PMID: 13638577 DOI: 10.1002/bjs.18004619815] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Costantini R, Di Bartolomeo N, Francomano F, Angelucci D, Innocenti P. Epithelioid angiosarcoma of the gallbladder: case report. J Gastrointest Surg 2005; 9:822-5. [PMID: 15985238 DOI: 10.1016/j.gassur.2005.01.286] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2004] [Revised: 01/05/2005] [Accepted: 01/31/2005] [Indexed: 01/31/2023]
Abstract
A patient with epithelioid angiosarcoma of the gallbladder is described. This is only the second case of an extremely rare but highly aggressive tumor reported in the international literature. Pathophysiological, clinical, and therapeutic aspects are discussed in relation to the available data on angiosarcomas of the gallbladder.
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Affiliation(s)
- Raffaele Costantini
- Department of General Surgery, G. D'Annunzio University of Chieti, Chieti, Italy.
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44
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Themistocleous GS, Papagelopoulos PJ, Petraki KD, Stilianessi EV, Partsinevelos AA, Sapkas GS. A 23-year-old woman with complete paraplegia and anesthesia below the T8 level. Clin Orthop Relat Res 2005:258-65. [PMID: 15662333 DOI: 10.1097/01.blo.0000150455.62479.37] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Abstract
Degenerative changes resembling hemophilic arthropathy may be a complication of synovial hemangioma in the knee. It is thought that arthropathy is caused by repeated bleeding episodes similar to the joint disease in hemophilia. Four children aged 4 to 9 years at surgery were treated by anterior open synovectomy for intra-articular synovial hemangiomas. At open surgery the cartilage of all patients showed changes on the surface with yellow hematin staining in all cases, without ulceration in three patients but one, who showed severe degenerative changes at age 9 years. At 15 months follow-up the patient with severe degenerative changes had severely impaired flexion and mild extension deficit. The three others were asymptomatic at 1 to 6 years follow-up. The magnetic resonance images were typical and can be considered pathognomonic; however, the referral diagnosis included the correct diagnosis in none of them. Treatment should be initiated as early as possible to reduce the risk of damage to the cartilage. Treatment by complete open synovectomy in these four patients was performed without significant bleeding problems, and no recurrence was seen.
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Aflatoon K, Staals E, Bertoni F, Bacchini P, Donati D, Fabbri N, Boriani S, Frassica FJ. Hemangioendothelioma of the spine. Clin Orthop Relat Res 2004:191-7. [PMID: 15043114 DOI: 10.1097/00003086-200401000-00031] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
A review of the patient files from our institution's oncology department showed that between 1950 and 2000, 11 patients were diagnosed with hemangioendothelioma of the spine, a rare, low-grade malignant vascular tumor. After reevaluation of the diagnoses by orthopaedic oncologists and pathologists, three patients were excluded; therefore eight patients formed the study group. The eight lesions were located in the thoracic (three) or lumbar spine (five, one in each vertebral level). Computed tomography scans revealed expansile lytic process. All lesions involved the vertebral body, but only one was diffuse with spinous process involvement. Treatment included: external beam irradiation alone (one patient), curettage and external beam irradiation (one patient), laminectomy and external beam irradiation (two patients), anterior resection only (two patients), and anterior resection with postoperative external beam irradiation (two patients). Patients without spinal stabilization had chronic low back pain; no patient with spinal stabilization had such pain. One patient who had surgical resection and radiation therapy had a radiation-induced sarcoma develop after 4 years. One patient who was treated with radiation therapy alone had a metastatic lung lesion develop. No other patient had tumor recurrence or progression. Therefore, patients with hemangioendothelioma of the spine may be treated with radiation therapy alone, surgery alone, or a combination thereof. However, because the number of patients in the current series was small, no definitive recommendations regarding treatment may be made. Resection of large lesions and stabilization of vertebral collapse may decrease back pain.
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Affiliation(s)
- Kamran Aflatoon
- Department of Orthopaedic Surgery, Johns Hopkins University/Johns Hopkins Bayview Medical Center, Baltimore, Maryland 21224-2780, USA
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Cansiz H, Yener M, Dervisoglu S, Kalekoglu N. Hemangioendothelioma of the Frontal Bone in a Child. J Craniofac Surg 2003; 14:724-8. [PMID: 14501337 DOI: 10.1097/00001665-200309000-00023] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Hemangioendothelioma is a vascular tumor of endothelial cell origin. It may involve bone or soft tissues and can behave like a benign or malignant tumor. In the literature, there are several case reports on the involvement of the head and neck region, but involvement of the frontal bone is extremely rare. This report presents the case of a 4-year-old boy with the diagnosis of spindle cell hemangioendothelioma of the frontal bone, who was treated by wide surgical resection.
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Affiliation(s)
- Harun Cansiz
- Department of Otorhinolaryngology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
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Affiliation(s)
- Jin-Shing Chen
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
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