Hemangioma, hemangiopericytoma, and hemangioendothelioma (angiosarcoma) of bone

Unni, K. Krishnan; Ivins, John C.; Beabout, John W.; Dahlin, David C.

doi:10.1002/1097-0142(197106)27:6<1403::aid-cncr2820270621>3.0.co;2-6

Cited by 209 publications

(83 citation statements)

References 10 publications

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“…The tumor in our patient was diffusely and intensely immunoreactive for CD31. However, because CD31 positivity also is observed in carcinomas and mesotheliomas, albeit weakly [14], it is advisable to use multiple endothelial markers for the immunohistochemical diagnosis of angiosarcoma. Therefore, in our case, immunohistochemical staining of vimentin, CD34, CD68, and epithelial membrane antigen also were performed.…”

Section: Discussion and Treatmentmentioning

confidence: 99%

Orthopaedic · Radiology · Pathology Conference: Left Hip Pain in a 62-year-old Man

Zhao

Fan

2009

Clinical Orthopaedics &Amp; Related Research

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A 62-year-old man was referred for dull pain of the anterolateral side of his left hip with limited motion for 2 months duration. The pain radiated to the left knee, became worse after long periods of walking or standing, and was not relieved with common analgesics. The pain gradually worsened, and began awakening him at night. He had no history of previous trauma or hip disease. During these 2 months, his body weight decreased by approximately 10 kg. He had no fever, chill, or night sweats.On physical examination, the patient had deep tenderness in the left groin and over the greater trochanter and pain in the left hip when striking the left heel in the straight leg position. There was no swelling, deformity, varicosity, or redness. Sensation was normal, and skin temperature was a bit higher than that of the right hip. The range of motion was decreased: flexion-extension, 75°to -5°; internal-external rotation, 15°to -20°; abduction-adduction, 15°to -25°; however, motion of the left knee and ankle was normal.Laboratory studies, including complete blood count, erythrocyte sedimentation rate, serum chemistries, and carcinoma markers were unremarkable. Plain radiographs ( Fig. 1) and computed tomography (CT) scans of the left hip and pelvis (Fig. 2) were obtained.Based on the history, physical findings, and imaging studies, what is the differential diagnosis? Imaging InterpretationAnteroposterior plain radiographs of the pelvis showed irregularly expansive, loculated lytic bone destruction, especially the medial cortex, with surrounding sclerosis and internal septation and scattered internal calcification in the metaphysis of the left femur and femoral head (Fig. 1), but no periosteal reaction or soft tissue extension was present. CT scans showed a large osteolytic lesion with calcifications and mixed density in the femoral head and intertrochanteric region with erosion of its medial cortex with marked thinning and destruction of the cortex posteromedially and thickening anteriorly. Some swelling of the soft tissue also was seen (Fig. 2). CT scans of the chest did not show any obvious metastasis. Technetium 99 bone scintigraphy showed the lesion was localized in the proximal part of the left femur.

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Section: Discussion and Treatmentmentioning

confidence: 99%

Orthopaedic · Radiology · Pathology Conference: Left Hip Pain in a 62-year-old Man

Zhao

Fan

2009

Clinical Orthopaedics &Amp; Related Research

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“…Patients with skull angiosarcoma have a poor outcome although long-term survivors have been occasionally seen [22]. Their prognosis is worse prognosis than for other bone angiosarcomas because of the frequent secondarily involvement of the meninges and the brain and the difficulty to perform a complete surgical resection.…”

Section: Discussionmentioning

confidence: 99%

Primary temporal bone angiosarcoma: a case report

et al. 2005

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SummaryWe present a rare case of temporal bone angiosarcoma diagnosed in a 26-year-old female patient at 36 week of pregnancy. The patient was referred with a 2 months history of left otalgia and tinnitus with a tender swelling above the mastoid. Cranial imaging studies showed a 7 × 5 × 4 cm hypervascularized mass located in the left middle fossa with lysis of the temporal bone and extension to the subcutis. After the baby was delivered by caesarean section, the patient entered the oncology protocol. Selective embolization of the feeding vessels was followed by gross total surgical resection using a combined supra-and infra-tentorial approach. Pathological findings were those of a poorly differentiated, highly malignant sarcoma with a large epitheloid component and immunohistochemical evidence of endothelial differentiation (CD31, Factor VIII related antigen, CD34), consistent with an angiosarcoma with epitheloid features. No extra-cranial tumor was found after extensive staging. The patient received adjuvant radiotherapy followed by a course of chemotherapy consisting of 6 cycles of paclitaxel. At 15 months follow-up, she developed multiple distant metastasis to a left postauricular lymph node and to the lungs and ribs. The patient was given a second line chemotherapy using doxorubicine and ifosfamide. Despite an initial good response, she died with metastatic disease 26 months after diagnosis. We present a rare case of primary temporal bone angiosarcoma and report our experience with a multimode therapeutic approach combining surgery, radiotherapy and chemotherapy.

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“…Cutaneous lesions at the same dorsal segment as the deep lesion are present in some cases [5]. The lesion consists of abnormal vessels and it causes bone resorption, producing a honeycomb appearance [30,33,43].…”

Section: Discussionmentioning

confidence: 99%

“…Multiple hemangiomas of the bone are more common in generalized diseases involving the spine, skull and pelvis as well as the liver and other organs [7,23,43]. Reports of multiple hemangiomas of the spine are rare in the literature [3, 23,34].…”

Section: Discussionmentioning

confidence: 99%

Pain pattern in multiple vertebral hemangiomas involving non-adjacent levels: report of two cases

Korres

Karachalios

Roidis

et al. 2000

European Spine Journal

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IntroductionHemangioma is a benign tumor consisting of blood vessels. There are two types: generalized and localized. In the generalized type there is involvement of multiple organs such as the liver, skin and bone [7]. Localized hemangiomas are the most common. In the skeleton, the most common site is the spine, followed by the skull and pelvis. Hemangiomas are often asymptomatic and discovered accidentally, but they may cause back pain or spinal cord compression in some cases. Radiographic and CT evidence of the hemangioma are characteristic. Multiple lesions of the spine are rather uncommon. Management of the patient depends on the severity of the symptoms, and may be either conservative or surgical.We present the cases of two patients with multiple hemangiomas of the spine involving multiple non-adjacent vertebrae and we comment on the possible clinical significance of their presentation. Case reports Case 1A 68-year-old man initially presented at the outpatient clinic because of persistent low back-pain. Radiographs revealed hemangiomas of the L3 and L4 vertebrae (Fig. 1). Conventional radiographs of the upper spine were normal. The patient was treated by conservative means. He was given non-steroidal anti-inflammatory drugs (NSAID) and a course of physiotherapy, and he was soon symptom free. At a follow up examination 1 year later, he was symptom free and was discharged. He was advised to attend annual follow-up examinations but did not.The patient came back to the clinic 15 years later complaining of suffering acute back pain localized in the area of T8-T10 during the previous 3 months. Common pain-killers gave him no relief. On examination, there was no evidence of neurologic involvement,

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Hemangioma, hemangiopericytoma, and hemangioendothelioma (angiosarcoma) of bone

Cited by 209 publications

References 10 publications

Orthopaedic · Radiology · Pathology Conference: Left Hip Pain in a 62-year-old Man

Orthopaedic · Radiology · Pathology Conference: Left Hip Pain in a 62-year-old Man

Primary temporal bone angiosarcoma: a case report

Pain pattern in multiple vertebral hemangiomas involving non-adjacent levels: report of two cases

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