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Angiosarcoma: Osseous
B.J. Manaster, MD, PhD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Clinical Issues

        • Diagnostic Checklist

          TERMINOLOGY

          • Synonyms

            • Hemangiosarcoma
            • Hemangioendothelial sarcoma
            • Epithelioid angiosarcoma
          • Definitions

            • Aggressive malignant vascular tumor
              • Cells show endothelial differentiation

          IMAGING

          • General Features

            • Imaging Recommendations

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Nuclear Medicine Findings

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Staging, Grading, & Classification

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Image Interpretation Pearls

                                          Selected References

                                          1. Verbeke SL et al: Array CGH analysis identifies two distinct subgroups of primary angiosarcoma of bone. Genes Chromosomes Cancer. 54(2):72-81, 2015
                                          2. Balaji GG et al: Primary epithelioid angiosarcoma of the calcaneum: a diagnostic dilemma. J Foot Ankle Surg. 53(2):239-42, 2014
                                          3. Palmerini E et al: Primary angiosarcoma of bone: a retrospective analysis of 60 patients from 2 institutions. Am J Clin Oncol. 37(6):528-34, 2014
                                          4. Sakamoto A et al: Aggressive clinical course of epithelioid angiosarcoma in the femur: a case report. World J Surg Oncol. 12:281, 2014
                                          5. Griffith B et al: Angiosarcoma of the humerus presenting with fluid-fluid levels on MRI: a unique imaging presentation. Skeletal Radiol. 42(11):1611-6, 2013
                                          6. Thariat J et al: Primary multicentric angiosarcoma of bone: true entity or metastases from an unknown primary? Value of comparative genomic hybridization on paraffin embedded tissues. Rare Tumors. 5(3):e53, 2013
                                          7. Errani C et al: Vascular bone tumors: a proposal of a classification based on clinicopathological, radiographic and genetic features. Skeletal Radiol. 41(12):1495-507, 2012
                                          8. Dunlap JB et al: Cytogenetic analysis of a primary bone angiosarcoma. Cancer Genet Cytogenet. 194(1):1-3, 2009
                                          9. Asmane I et al: Adriamycin, cisplatin, ifosfamide and paclitaxel combination as front-line chemotherapy for locally advanced and metastatic angiosarcoma. Analysis of three case reports and review of the literature. Anticancer Res. 28(5B):3041-5, 2008
                                          10. Abraham JA et al: Treatment and outcome of 82 patients with angiosarcoma. Ann Surg Oncol. 14(6):1953-67, 2007
                                          11. Marthya A et al: Multicentric epithelioid angiosarcoma of the spine: a case report of a rare bone tumor. Spine J. 7(6):716-9, 2007
                                          12. Mittal S et al: Post-irradiation angiosarcoma of bone. J Cancer Res Ther. 3(2):96-9, 2007
                                          13. Deshpande V et al: Epithelioid angiosarcoma of the bone: a series of 10 cases. Am J Surg Pathol. 27(6):709-16, 2003
                                          14. Santeusanio G et al: Multifocal epithelioid angiosarcoma of bone: a potential pitfall in the differential diagnosis with metastatic carcinoma. Appl Immunohistochem Mol Morphol. 11(4):359-63, 2003
                                          15. McDonald DJ et al: Metal-associated angiosarcoma of bone: report of two cases and review of the literature. Clin Orthop Relat Res. (396):206-14, 2002
                                          16. Roessner A et al: Angiosarcoma. In Fletcher CDM et al: World Health Organization classification of Tumours: Tumours of soft tissue and bone. Lyon: IARC Press, 2002
                                          17. Choi JJ et al: Angiomatous skeletal lesions. Semin Musculoskelet Radiol. 4(1):103-12, 2000
                                          18. Wenger DE et al: Malignant vascular lesions of bone: radiologic and pathologic features. Skeletal Radiol. 29(11):619-31, 2000
                                          19. Abdelwahab IF et al: Angiosarcomas associated with bone infarcts. Skeletal Radiol. 27(10):546-51, 1998
                                          20. Boulanger V et al: Primary angiosarcoma of bone in Paget's disease. Eur J Surg Oncol. 24(6):611-3, 1998
                                          21. Greenspan A et al: Differential diagnosis of tumors and tumor-like lesions of bones and joints. Philadelphia: Lippincott-Raven, 1998
                                          22. Lomasney LM et al: Multifocal vascular lesions of bone: imaging characteristics. Skeletal Radiol. 25(3):255-61, 1996
                                          23. Murphey MD et al: From the archives of the AFIP. Musculoskeletal angiomatous lesions: radiologic-pathologic correlation. Radiographics. 15(4):893-917, 1995
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Clinical Issues

                                                • Diagnostic Checklist

                                                  TERMINOLOGY

                                                  • Synonyms

                                                    • Hemangiosarcoma
                                                    • Hemangioendothelial sarcoma
                                                    • Epithelioid angiosarcoma
                                                  • Definitions

                                                    • Aggressive malignant vascular tumor
                                                      • Cells show endothelial differentiation

                                                  IMAGING

                                                  • General Features

                                                    • Imaging Recommendations

                                                      • Radiographic Findings

                                                        • CT Findings

                                                          • MR Findings

                                                            • Nuclear Medicine Findings

                                                              DIFFERENTIAL DIAGNOSIS

                                                                PATHOLOGY

                                                                • General Features

                                                                  • Staging, Grading, & Classification

                                                                    • Gross Pathologic & Surgical Features

                                                                      • Microscopic Features

                                                                        CLINICAL ISSUES

                                                                        • Presentation

                                                                          • Demographics

                                                                            • Natural History & Prognosis

                                                                              • Treatment

                                                                                DIAGNOSTIC CHECKLIST

                                                                                • Image Interpretation Pearls

                                                                                  Selected References

                                                                                  1. Verbeke SL et al: Array CGH analysis identifies two distinct subgroups of primary angiosarcoma of bone. Genes Chromosomes Cancer. 54(2):72-81, 2015
                                                                                  2. Balaji GG et al: Primary epithelioid angiosarcoma of the calcaneum: a diagnostic dilemma. J Foot Ankle Surg. 53(2):239-42, 2014
                                                                                  3. Palmerini E et al: Primary angiosarcoma of bone: a retrospective analysis of 60 patients from 2 institutions. Am J Clin Oncol. 37(6):528-34, 2014
                                                                                  4. Sakamoto A et al: Aggressive clinical course of epithelioid angiosarcoma in the femur: a case report. World J Surg Oncol. 12:281, 2014
                                                                                  5. Griffith B et al: Angiosarcoma of the humerus presenting with fluid-fluid levels on MRI: a unique imaging presentation. Skeletal Radiol. 42(11):1611-6, 2013
                                                                                  6. Thariat J et al: Primary multicentric angiosarcoma of bone: true entity or metastases from an unknown primary? Value of comparative genomic hybridization on paraffin embedded tissues. Rare Tumors. 5(3):e53, 2013
                                                                                  7. Errani C et al: Vascular bone tumors: a proposal of a classification based on clinicopathological, radiographic and genetic features. Skeletal Radiol. 41(12):1495-507, 2012
                                                                                  8. Dunlap JB et al: Cytogenetic analysis of a primary bone angiosarcoma. Cancer Genet Cytogenet. 194(1):1-3, 2009
                                                                                  9. Asmane I et al: Adriamycin, cisplatin, ifosfamide and paclitaxel combination as front-line chemotherapy for locally advanced and metastatic angiosarcoma. Analysis of three case reports and review of the literature. Anticancer Res. 28(5B):3041-5, 2008
                                                                                  10. Abraham JA et al: Treatment and outcome of 82 patients with angiosarcoma. Ann Surg Oncol. 14(6):1953-67, 2007
                                                                                  11. Marthya A et al: Multicentric epithelioid angiosarcoma of the spine: a case report of a rare bone tumor. Spine J. 7(6):716-9, 2007
                                                                                  12. Mittal S et al: Post-irradiation angiosarcoma of bone. J Cancer Res Ther. 3(2):96-9, 2007
                                                                                  13. Deshpande V et al: Epithelioid angiosarcoma of the bone: a series of 10 cases. Am J Surg Pathol. 27(6):709-16, 2003
                                                                                  14. Santeusanio G et al: Multifocal epithelioid angiosarcoma of bone: a potential pitfall in the differential diagnosis with metastatic carcinoma. Appl Immunohistochem Mol Morphol. 11(4):359-63, 2003
                                                                                  15. McDonald DJ et al: Metal-associated angiosarcoma of bone: report of two cases and review of the literature. Clin Orthop Relat Res. (396):206-14, 2002
                                                                                  16. Roessner A et al: Angiosarcoma. In Fletcher CDM et al: World Health Organization classification of Tumours: Tumours of soft tissue and bone. Lyon: IARC Press, 2002
                                                                                  17. Choi JJ et al: Angiomatous skeletal lesions. Semin Musculoskelet Radiol. 4(1):103-12, 2000
                                                                                  18. Wenger DE et al: Malignant vascular lesions of bone: radiologic and pathologic features. Skeletal Radiol. 29(11):619-31, 2000
                                                                                  19. Abdelwahab IF et al: Angiosarcomas associated with bone infarcts. Skeletal Radiol. 27(10):546-51, 1998
                                                                                  20. Boulanger V et al: Primary angiosarcoma of bone in Paget's disease. Eur J Surg Oncol. 24(6):611-3, 1998
                                                                                  21. Greenspan A et al: Differential diagnosis of tumors and tumor-like lesions of bones and joints. Philadelphia: Lippincott-Raven, 1998
                                                                                  22. Lomasney LM et al: Multifocal vascular lesions of bone: imaging characteristics. Skeletal Radiol. 25(3):255-61, 1996
                                                                                  23. Murphey MD et al: From the archives of the AFIP. Musculoskeletal angiomatous lesions: radiologic-pathologic correlation. Radiographics. 15(4):893-917, 1995