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Sarcomas
Published in E. George Elias, CRC Handbook of Surgical Oncology, 2020
Tumors of vascular endothelial origin—include angiosarcoma, lymphangiosarcoma, and hemangiopericytoma. Angiosarcomas are common in elderly people in the scalp. They also do occur in the skin, breast, and the liver (Figure 1). Vinyl chloride exposure has been blamed as etiological factor. They have a spongy or blood blister appearance. Lymphangiosarcoma is a rare tumor that used to be frequently seen in the arms of patients who underwent a radical mastectomy and radiation therapy. It arises in a long standing lymphatic obstruction of 10 to 20 years (Figure 2). The survival is poor and lung metastases are common. Hemangiopericytomas do occur in all age groups and sites, but mainly in the lower extremities and retroperitoneum and pelvis. Histologically, this tumor may mimic synovial sarcoma.
Vascular tumours and malformation
Published in Brice Antao, S Irish Michael, Anthony Lander, S Rothenberg MD Steven, Succeeding in Paediatric Surgery Examinations, 2017
Cameron C Trenor III, Steven J Fishman, Arin K Greene
Infantile haemangioma appears within the first 2 weeks of life and enlarges rapidly for several months; after 1 year of age it begins to slowly regress. Rapidly involuting congenital haemangioma is a purplish lesion that is present at birth and has completely regressed by 1 year of age. Non-involuting congenital haemangioma is a purplish lesion present at birth that does not undergo involution. Kaposiform haemangioendothelioma cutaneous lesions are firm and purple, may be present at birth or arise in infancy and are often complicated by severe thrombocytopenia and bleeding. Tufted angioma is a milder tumour on the same neoplastic spectrum as kaposiform haemangioendothelioma. Angiosarcoma is a malignant neoplasm with a high mortality rate, typically occurring in adults. Epithelioid haemangioendothelioma may be a low- or a high-grade malignancy and usually affects the liver, lungs and bone. Pyogenic granuloma is a small vascular lesion that commonly affects the face of children at an average age of 6 years; it frequently causes bleeding. Cutaneovisceral angiomatosis with thrombocytopenia is often present at birth and is associated with multiple cutaneous lesions, thrombocytopenia and gastrointestinal bleeding due to visceral lesions.
Histopathologic Classification of Human Sinonasal Tumors
Published in Gerd Reznik, Sherman F. Stinson, Nasal Tumors in Animals and Man, 2017
The important fact related to the foregoing is that malignant vasoformative neoplasms of the sinonasal tract are quite rare and a diagnosis such as angiosarcoma or hemangioendothelial sarcoma should be made with much hesitation. The benign lesions discussed above which can be mistaken for malignancies are much more likely to be encountered than a true angiosarcoma.
Angiosarcoma after endovascular aneurysm repair: case report and literature review
Published in Acta Chirurgica Belgica, 2023
Stefanie Pecceu, Isabelle Van Herzeele, Ellen Deolet, Jo Van Dorpe, Nathalie Moreels, Liesbeth Desender, Frank Vermassen, Caren Randon
Angiosarcoma is a rare and aggressive malignant tumour accounting for 2% of soft tissue sarcomas and remains a true diagnostic challenge due to non–specific symptoms [1]. After implantation of an aortic graft, angiosarcomas are often mistaken for more common graft-related complications. Diagnosis is often made when the disease has already spread, after resection of the tumour or post-mortem. Radical surgical resection followed by adjuvant radiotherapy has the best prognosis but is rarely possible. The role of adjuvant chemotherapy and/or radiotherapy is debatable. Adjuvant chemotherapy with doxorubicin-containing agents demonstrated a significantly lower disease relapse and resulted in a trend for longer survival. However, survival rates of only 4% after 10 years were noted [1–3]. We report two cases of patients who previously underwent an endovascular aneurysm repair (EVAR), and were diagnosed with an epithelioid angiosarcoma. A narrative review of the published case reports of angiosarcomas after EVAR has also been conducted. The aim of this study was to analyse the clinical and immunohistochemical findings and to highlight the challenges associated with diagnosing an angiosarcoma after EVAR.
Development and validation of a prognostic nomogram model in primary cutaneous and subcutaneous soft tissue angiosarcoma
Published in Journal of Dermatological Treatment, 2022
Jinqian Mao, Jin Hu, Yunfei Chen, Yiqing Li, Xiaoqin Run
Angiosarcoma is a malignant tumor with a poor prognosis (1). Several studies report that PCA and PSCA commonly occur in elderly males (1,3,11). In the current study, the old and male patients showed higher incidence and poor prognosis, which could be attributed to the health status of elderly patients, occupations, and hormones. Fayette et al. (12) report that tumor size and histological grade are prognostic factors for angiosarcoma. Large lesions (tumor size > 5 cm) and high grade were related to a worse prognosis. Poor therapeutic outcomes for patients with large lesions and high grades may be associated with poor prognosis. Effects of other malignant tumors which are secondary to PCA and PSCA remain uncertain. In our study, patients diagnosed with PCA and PSCA only showed a worse prognosis. However, MPMT cases were few and there was no information on subsequent primary malignant tumors in the SEER database, thus this finding should be further explored. The tumor stage is an important factor that determines the prognosis (13). Patients diagnosed with distant metastasis showed a poor prognosis (1,14). The findings showed that stage IV characterized by distant metastasis had higher mortality.
Accidental discovery of metastasized basal cell carcinoma
Published in Acta Chirurgica Belgica, 2022
Hanne Verberght, Thomas Schok, Siebe Wouda, Frits Aarts
Skin lesions can have various distinct diagnoses such as SCC, angiosarcoma, cutaneous lymphoma, and melanoma. An SCC develops in the same way as does a BCC after a sunburn. SCC usually progresses more quickly and metastasizes more often, initially to the lymph nodes. Angiosarcoma is a skin cancer originating from the blood or lymph vessels and occurring most commonly in the head and neck regions. In addition, angiosarcomas are characterized by aggressive growth, and metastasis is common, resulting in a high mortality rate. The slow course and the location of the lesion in this patient make it less likely to be an angiosarcoma. Another possible diagnosis is cutaneous lymphoma, which can appear as an eczematous rash for years and subsequently develop into an ulcerative tumor. It originates from lymph nodes in the skin and develops slowly and often locally. The fact that the lesion in our patient developed after sunburn makes it less likely to be a cutaneous lymphoma. Melanoma is one of the top three most commonly skin cancers, followed by SCC and BCC. It presents as both pigmented and unpigmented melanoma. However, in this case, the diagnosis of melanoma was unlikely, considering the very slow evolution of the lesion.