Primary Peritoneal Angiosarcoma Metastatic to Liver and Bone without History of Radiation Therapy

Spontaneous splenic rupture as a primary manifestation of angiosarcoma: a case report

Angiosarcoma, a rare endothelial cell tumor, accounts for < 2% of all sarcomas, typically affecting elderly patients. We present the case of a 62-year-old male with a history of hypertension and ischemic heart disease, who initially presented with severe lower back pain. Subsequent imaging revealed a ruptured splenic lesion and multiple liver lesions, leading to a diagnosis of stage 4 angiosarcoma. Post-splenectomy, the patient exhibited pathological vertebral fractures and elevated liver function tests, consistent with metastatic disease. Despite aggressive surgical intervention and supportive care, the patient's condition remained critical. The treatment plan included palliative chemotherapy, spine radiotherapy, and ongoing pain management, with close monitoring of disease progression and response to therapy. This case describes the diagnostic challenges and poor prognosis associated with metastatic angiosarcoma.

Updates in Pathology for Retroperitoneal Soft Tissue Sarcoma

Retroperitoneal tumors are extremely rare. More than 70% of primary retroperitoneal soft tissue tumors are malignant. The most common sarcomas in the retroperitoneum include liposarcomas and leiomyosarcoma, however other sarcomas, along with benign mesenchymal tumors, can occur. Sarcomas are a heterogenous group of tumors with overlapping microscopic features, posing a diagnostic challenge for the pathologist. Correct tumor classification has become important for prognostication and the evolving targeted therapies for sarcoma subtypes. In this review, the pathology of retroperitoneal soft tissue sarcomas is discussed, which is important to the surgical oncologist. In addition, less common sarcomas and benign mesenchymal tumors of the retroperitoneum, which may mimic sarcoma clinically and pathologically, are also discussed.