Arteriovenous fistula-associated angiosarcoma

Angiosarcomas are a rare, aggressive, and insidious type of soft tissue sarcoma and are often misdiagnosed, causing delays in treatment. We report the case of a 53-year-old renal transplant patient with a thrombosed arteriovenous fistula who developed angiosarcoma that was incorrectly presumed to be a hematoma caused by trauma. Despite surgical resection and adjuvant radiation, the patient developed local recurrence proximal to the excision site and pulmonary metastasis. This case report highlights the importance of routine pathological analysis of symptomatic arteriovenous fistulas and prompts consideration for the early resection of arteriovenous fistulas post-transplant that demonstrate concerning changes.