Angiosarcomas

Definitions & Key takeaways

Angiosarcomas are rare and aggressive cancers that can develop from lymphatic or vascular endothelial cells. They can occur anywhere in the body, but most commonly arise in the scalp, breast, and chest. These tumors are often hard to diagnose early because they can mimic other more benign conditions.

Chapters:

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Introduction0:00–0:28

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.

Pathology0:28–2:05

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 eventually, can 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 at a very rapid rate and can be easily carried by blood flow or lymphatic flow to far- away sites of the body, particularly the lungs, where they form a new, metastatic tumor, and that’s why angiosarcomas are considered to be extremely aggressive.
Angiosarcomas can occur anywhere in the body, but most often involve the skin, bone, soft tissue, breast, or liver, and often spread to the lungs.
Angiosarcoma of the skin usually show up on the head or neck as a raised purplish skin area that looks like a bruise that does not heal and may bleed, be painful or be accompanied with swelling in the surrounding skin.
Angiosarcoma of the bone is usually multifocal, meaning that it affects multiple sites within the same bone, or involves multiple bones of the same limb.

Causes2:05–2:48

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.
That typically occurs when lymph nodes have been removed or damaged, and fluid in the tissues have no way of draining away.
Lymph nodes are sometimes surgically removed as part of cancer treatment, or may be destroyed by trauma infection, or may not be present because of a congenital problem.
Angiosarcomas in the liver have been associated with vinyl chloride gas which is found in PVC manufacturing and arsenic insecticide.

Signs and symptoms2:48–3:17

Symptoms of angiosarcoma depend on the affected organ. Soft tissue angiosarcomas can cause pain and swelling, and can compress peripheral nerves causing tingling, pricking or numbness.
In the breast, angiosarcomas form rapidly-growing, palpable masses, while in the liver, hepatic angiosarcomas can cause vague symptoms like fatigue and abdominal pain.
Metastasis of angiosarcoma to the lungs can cause chest pain and difficulty breathing. The diagnosis of angiosarcoma is based on a biopsy of the mass.

Diagnosis and treatment3:17–3:41

Imaging studies like an MRI or CT can help establish the location and extension of the cancer. Treatment of angiosarcoma depends on the location and extent of the tumor, and it can include surgery, chemotherapy, or radiotherapy or some combination of these three.

Review3:41–4:01

All right, as a quick recap, angiosarcoma is an aggressive cancer of the endothelial cells lining the walls of blood vessels or lymphatic vessels.
It usually affects the skin on the head and neck, soft tissue, bones, breast or liver, but also metastasizes quickly, particularly to the lungs.