Summary of Angiosarcoma
Flashcards on Angiosarcoma
Chronic arsenic poisoning increases the risk of developing angiosarcoma of the .
Questions on Angiosarcoma
A 58-year-old Caucasian man comes to the office because of dull abdominal pain and nausea. The patient refers that he has been working as a home builder for 25 years and that he is chronically exposed to phthalates and bisphenol A (BPA) related to weatherstripping material for houses. Medical history is relevant for hypertension, obesity, and recent travel to China. Physical examination shows pale skin and conjunctiva, hepatomegaly, and bilateral flank dullness. Abdominal computed tomography reveals a hypoattenuating mass with nodular enhancement in the liver. His temperature is 36.6°C (97.8°F), pulse is 92/min, respirations are 20/min, blood pressure is 140/80 mmHg, and saturation is 98%. Laboratory studies show α-fetoprotein of 10 ng/mL, negative hepatitis B and C serology. Which of the following is the most likely explanation for this patient’s findings?
Transcript for Angiosarcoma
In angiosarcoma, -sarcoma refers to a malignant tumor, and angio- refers to a blood vessel or a lymphatic vessel. So angiosarcoma is a cancer of either a blood vessel, in which case it’s called a hemangiosarcoma, or a cancer of a lymphatic vessel, in which case it’s called a lymphangiosarcoma. Both arise from the inner lining of the vessel wall, known as endothelium.
Angiosarcomas form when endothelial cells suddenly start proliferating abnormally. If these masses grow inside the blood vessel lumen, they can obstruct the blood flow, and that interferes with the oxygen and nutrient supply to various tissues, and can eventually result in tissue ischemia. If lymph flow is obstructed, lymph fluid backs up in the tissues, causing lymphedema.
Cancer cells from hemangiosarcomas and lymphangiosarcomas can also invade the vessel wall, destroying it and making it burst, leading to bleeding or lymph fluid outflow in the surrounding tissue. In general, these cancer cells multiply rapidly and can be easily carried by blood flow or lymphatic flow to far-off sites within the body, particularly the lungs, where they form a new, metastatic tumor or tumors. Because of this, angiosarcoma is considered to be a particularly aggressive type of cancer.
Angiosarcomas can occur anywhere in the body, but most often develop within the skin, bone, soft tissue, breast, or liver, and often spread from those locations to the lungs. Angiosarcoma of the skin usually shows up on the head or neck as a raised, purplish skin area that looks like a bruise that doesn’t heal; it may bleed, be painful, or be accompanied by swelling of the skin surrounding the affected area. Angiosarcoma of the bone is usually multifocal, meaning it affects multiple sites within the same bone, or involves multiple bones of the same limb.
The exact causes of angiosarcoma remain unknown. One risk factor is chronic lymphedema in some part of the body, like the arms or legs, that goes on for several years. This typically occurs when lymph nodes have been removed or damaged, and the fluid in the tissues has no way of draining away. Lymph nodes are sometimes surgically removed as part of cancer treatment, or destroyed by trauma infection, or they might not even have been present any point due to a congenital problem. Angiosarcomas in the liver have been associated with vinyl chloride gas, a by-product of PVC manufacturing that’s also found in arsenic insecticide.