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Intractable Bleeding After Revision Hip Arthroplasty Because of Angiosarcoma: A Report of 2 Cases
Arthur A Ter-Zakarian1,2, David M Joyce3, Steven Lyons2,4
1Foundation for Orthopaedic Research and Education, Tampa, Florida.
Case:
Two cases of revision total hip arthroplasty (THA) for pseudotumor and infection with persistent postoperative bleeding because of angiosarcoma are presented. After surgery, both patients' health deteriorated because of hypovolemic shock despite transfusion, pressors, embolization, and prothrombotics. Diagnosis was obscure and delayed despite extensive imaging. Standard and computed tomography angiogram were nondiagnostic and did not localize the tumors or bleeding. Repeat surgeries and biopsies requiring special staining ultimately revealed epithelioid angiosarcoma.
Conclusion:
A diagnosis of angiosarcoma was etiologic for persistent postoperative bleeding after revision THA and should be considered in such cases.
