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Epithelioid angiosarcoma of bone

T Hasegawa1, Y Fujii, K Seki

  • 1Department of Pathology, University of Tokushima School of Medicine, Komatsushima Red Cross Hospital, Japan.

Human Pathology
|August 1, 1997
PubMed
Summary

Epithelioid angiosarcoma of the bone is a rare vascular tumor. This case highlights its aggressive nature and provides diagnostic markers to differentiate it from metastatic carcinomas.

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Area of Science:

  • Orthopedic Oncology
  • Skeletal Pathology
  • Vascular Tumors

Background:

  • Angiosarcoma of bone is a rare, high-grade vascular sarcoma.
  • Epithelioid angiosarcoma presents a diagnostic challenge due to its mimicry of adenocarcinoma.

Observation:

  • A case of epithelioid angiosarcoma in the humerus of a 48-year-old man is described.
  • Radiological findings included a multilocular osteolytic lesion with cortical and medullary bone destruction and a soft tissue mass.
  • Histological examination revealed epithelioid morphology with sheet-like, pseudoglandular, and alveolar patterns.

Findings:

  • The tumor exhibited focal endothelial differentiation with intracytoplasmic lumina containing erythrocytes.
  • Immunohistochemistry showed positivity for cytokeratin and endothelial markers (factor-VIII related antigen, CD31, UEA-I).

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  • Ultrastructural analysis confirmed the angiosarcoma diagnosis.

    • Implications:

    • Skeletal epithelioid angiosarcoma has an aggressive clinical course, as evidenced by the patient's rapid disease progression.
    • Distinguishing this tumor from metastatic carcinomas requires awareness of its features and immunohistochemical analysis for endothelial markers.
    • Intracytoplasmic lumina and vasoformative foci are key diagnostic clues.