Angiosarcoma arising in an arteriovenous fistula in a patient without kidney transplant

Angiosarcomas are relatively rare and account for only 1% of all sarcomas. They arise from endothelial cells of blood or lymph vessels. They are usually highly aggressive and long term outcome is poor with an overall 5-year survival rate of 10-20%. We report the case of a 80-year old man with an angiosarcoma arising in a non-functioning arteriovenous fistula. Angiosarcomas arising in an arteriovenous fistula are very rare and only eleven cases were found in the literature. In nine cases (82%) chronic immunosuppression, taken for renal transplant, was one of the causing factors. Our patient however did not receive a kidney transplant and was not on immunosuppressive therapy. Clinicians should be aware that an angiosarcoma can arise in an arteriovenous fistula even without chronic immunosuppression.