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Related Concept Videos

Aneurysm II: Clinical Manifestations and Diagnostic Studies01:21

Aneurysm II: Clinical Manifestations and Diagnostic Studies

Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...

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Aortic Angiosarcoma Manifesting as Multiple Musculoskeletal Metastases: A Case Report.

Won Jong Bahk1, Sae Jung Na2, In Yong Whang2

  • 1Department of Orthopedic Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea.

Diagnostics (Basel, Switzerland)
|April 26, 2024
PubMed
Summary

Metastatic aortic angiosarcoma, a rare cancer, often presents as bone and soft tissue tumors. Positron emission tomography/computed tomography (PET/CT) scans are crucial for detecting the primary aortic lesion and diagnosing this challenging condition.

Keywords:
angiosarcomaaortabone metastasismusculoskeletal metastasispositron emission tomography (PET)

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Area of Science:

  • Oncology
  • Radiology
  • Pathology

Background:

  • Aortic angiosarcomas are exceptionally rare vascular tumors.
  • Their metastatic presentation often mimics other musculoskeletal conditions, complicating diagnosis.
  • Early identification is critical for effective patient management.

Purpose of the Study:

  • To detail the clinicopathological and radiologic features of a metastatic aortic angiosarcoma.
  • To highlight the diagnostic utility of advanced imaging in identifying primary lesions.
  • To emphasize the role of immunohistochemistry in confirming angiosarcoma diagnosis.

Main Methods:

  • Case report of a 59-year-old male with metastatic aortic angiosarcoma.
  • Utilized plain radiography, computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography/computed tomography (PET/CT).
  • Performed pelvic biopsy with histopathological examination and immunohistochemistry (vimentin, CD31, ERG).

Main Results:

  • Patient presented with thigh pain and multifocal osteolytic lesions.
  • Imaging revealed extensive bone and soft tissue metastases.
  • PET/CT identified increased uptake in the lower abdominal aorta, presumed primary site.
  • Biopsy confirmed epithelioid angiosarcoma with characteristic vasoformative features and immunoprofile.

Conclusions:

  • Metastatic aortic angiosarcoma can present insidiously with musculoskeletal symptoms.
  • PET/CT is invaluable for detecting the primary aortic tumor and staging metastatic disease.
  • Immunohistochemistry is essential for diagnosing epithelioid angiosarcoma in metastatic biopsies.