Angiosarcomas

7,611views

00:00 / 00:00

Videos

Notes

Angiosarcomas

Pathology

Vascular disorders

Arterial disease

Angina pectoris

Stable angina

Unstable angina

Myocardial infarction

Prinzmetal angina

Coronary steal syndrome

Peripheral artery disease

Subclavian steal syndrome

Aneurysms

Aortic dissection

Vasculitis

Behcet's disease

Kawasaki disease

Hypertension

Hypertensive emergency

Renal artery stenosis

Coarctation of the aorta

Cushing syndrome

Conn syndrome

Pheochromocytoma

Polycystic kidney disease

Hypotension

Orthostatic hypotension

Abetalipoproteinemia

Familial hypercholesterolemia

Hypertriglyceridemia

Hyperlipidemia

Chronic venous insufficiency

Thrombophlebitis

Deep vein thrombosis

Lymphedema

Lymphangioma

Shock

Vascular tumors

Human herpesvirus 8 (Kaposi sarcoma)

Angiosarcomas

Congenital heart defects

Truncus arteriosus

Transposition of the great vessels

Total anomalous pulmonary venous return

Tetralogy of Fallot

Hypoplastic left heart syndrome

Patent ductus arteriosus

Ventricular septal defect

Coarctation of the aorta

Atrial septal defect

Cardiac arrhythmias

Atrial flutter

Atrial fibrillation

Premature atrial contraction

Atrioventricular nodal reentrant tachycardia (AVNRT)

Wolff-Parkinson-White syndrome

Ventricular tachycardia

Brugada syndrome

Premature ventricular contraction

Long QT syndrome and Torsade de pointes

Ventricular fibrillation

Atrioventricular block

Bundle branch block

Pulseless electrical activity

Valvular disorders

Tricuspid valve disease

Pulmonary valve disease

Mitral valve disease

Aortic valve disease

Cardiomyopathies

Dilated cardiomyopathy

Restrictive cardiomyopathy

Hypertrophic cardiomyopathy

Heart failure

Heart failure

Cor pulmonale

Cardiac infections

Endocarditis

Myocarditis

Rheumatic heart disease

Pericardial disorders

Pericarditis and pericardial effusion

Cardiac tamponade

Dressler syndrome

Cardiac tumors

Cardiac tumors

Cardiovascular system pathology review

Acyanotic congenital heart defects: Pathology review

Cyanotic congenital heart defects: Pathology review

Atherosclerosis and arteriosclerosis: Pathology review

Coronary artery disease: Pathology review

Peripheral artery disease: Pathology review

Valvular heart disease: Pathology review

Cardiomyopathies: Pathology review

Heart failure: Pathology review

Supraventricular arrhythmias: Pathology review

Ventricular arrhythmias: Pathology review

Heart blocks: Pathology review

Aortic dissections and aneurysms: Pathology review

Pericardial disease: Pathology review

Endocarditis: Pathology review

Hypertension: Pathology review

Shock: Pathology review

Vasculitis: Pathology review

Cardiac and vascular tumors: Pathology review

Dyslipidemias: Pathology review

Assessments

Angiosarcomas

Flashcards

0 / 12 complete

USMLE® Step 1 questions

0 / 1 complete

High Yield Notes

5 pages

Flashcards

Angiosarcomas

of complete

Questions

USMLE® Step 1 style questions USMLE

of complete

A 58-year-old Caucasian man comes to the office because of dull abdominal pain and nausea for the past 2 months. The pain is located at the right side of the abdomen, and the patient rates it 4/10 in intensity. The patient has worked as an engineer in a PVC pipe factory for the past 35 years. Medical history is relevant for hypertension, obesity, and recent travel to China. His temperature is 37.0°C (98.6°F), pulse is 80/min, and blood pressure is 135/85 mmHg. Physical examination shows pale skin and conjunctiva, hepatomegaly, and shifting dullness to percussion. Abdominal computed tomography reveals a hypoattenuating, solitary mass with nodular enhancement in the liver. Immunostaining is positive for CD31. Serum alpha-fetoprotein is 8 ng/mL (normal value <10 ng/mL). Serology is negative for hepatitis B and C. Which of the following is the most likely cause for this patient’s presentation?  

Transcript

Content Reviewers

Rishi Desai, MD, MPH

Contributors

Marisa Pedron

Tanner Marshall, MS

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.

Summary

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.

Sources

  1. "Robbins Basic Pathology" Elsevier (2017)
  2. "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
  3. "Pathophysiology of Disease: An Introduction to Clinical Medicine 8E" McGraw-Hill Education / Medical (2018)
  4. "Angiosarcoma: clinical and imaging features from head to toe" The British Journal of Radiology (2017)
  5. "Angiosarcoma" The Lancet Oncology (2010)
Elsevier

Copyright © 2023 Elsevier, except certain content provided by third parties

Cookies are used by this site.

USMLE® is a joint program of the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME). COMLEX-USA® is a registered trademark of The National Board of Osteopathic Medical Examiners, Inc. NCLEX-RN® is a registered trademark of the National Council of State Boards of Nursing, Inc. Test names and other trademarks are the property of the respective trademark holders. None of the trademark holders are endorsed by nor affiliated with Osmosis or this website.

RELX