A Metal-Associated Epithelioid Angiosarcoma: A Case Report and Literature Review

Area of Science:

• Orthopedic oncology
• Vascular tumors
• Skeletal malignancies

Background:

• Angiosarcoma is a rare, aggressive bone malignancy (<1% of bone sarcomas).
• Epithelioid angiosarcoma, a subtype, presents with pleomorphic cells and vascular differentiation, often in deep soft tissues.
• Association with orthopedic implants or foreign bodies is exceptionally rare.

Purpose of the Study:

• To report a rare case of epithelioid angiosarcoma.
• To discuss the diagnostic challenges in cases with orthopedic implants and prior trauma.
• To highlight the importance of considering rare malignancies in complex orthopedic cases.

Main Methods:

• Case report presentation.
• Review of patient history including ballistic injury and intramedullary nail fixation.
• Histopathological analysis of the tumor.

Main Results:

• A 54-year-old male presented with epithelioid angiosarcoma.
• The patient had a history of proximal femur ballistic injury and intramedullary nail fixation.
• Initial diagnosis was misconstrued as chronic osteomyelitis.

Conclusions:

• Epithelioid angiosarcoma can arise in the context of orthopedic implants and prior ballistic trauma.
• Misdiagnosis as chronic osteomyelitis can occur, underscoring the need for vigilance.
• This case emphasizes the importance of thorough evaluation for rare bone tumors in patients with complex orthopedic histories.