Vascular tumors

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Vascular tumors


Cardiac tumors

Cardiac tumors




Vascular tumors


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USMLE® Step 1 questions

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High Yield Notes

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Vascular tumors

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USMLE® Step 1 style questions USMLE

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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?  

External References

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HIV (human immunodeficiency virus) p. 175

Kaposi sarcoma p. 165, 478

Human herpesvirus 8 (HHV-8) p. 165, 177

Kaposi sarcoma p. 478

Kaposi sarcoma p. 478

AIDS and p. 184

bacillary angiomatosis vs p. 478

HHV p. --13, 165

HIV-positive adults p. 177

IFN- αfor p. 204

oncogenic microbes and p. 226

Skin lesions

Kaposi sarcoma p. 165


Vascular tumors are tumors of the blood vessels, and there actually a lot of different types, so this is just a quick overview of three types of tumors: Kaposi sarcoma, hemangioma, and angiosarcoma. Kaposi sarcoma is a malignant vascular tumor that is linked with an infection of the human herpesvirus 8 (otherwise known as HHV-8). And it’s a cancer of the blood vessel endothelial cells. This virus is thought to get inside of the cells, and cause the cells to replicate uncontrollably. This type of cancer is seen in people who have suppressed immune systems. That’s why it’s one of the common diseases you’re at risk of getting if you have AIDS, and is a complication of organ transplant patients.

The most common symptoms of Kaposi sarcoma affect the skin, causing purple and red lesions. These lesions look somewhat like a bruise, but unlike a bruise they don’t blanch, or turn pale, when pressed. That’s because a Kaposi sarcoma has blood filled blood vessels whereas bruises are caused by blood leaking outside of blood vessels into the skin. Initially these lesions start off flat, but over time they may become raised and more painful. In people who have a compromised immune systems, the disease can also cause lesions in other tissues like the mouth, the nose, the throat, the lymph nodes, the lungs, and the gastrointestinal tract.

You can sometimes treat affected skin by surgically removing it or freezing it using cryotherapy, however treating the disease in immunocompromised patients is a little more difficult. If someone’s immune system is compromised because of drugs such as corticosteroids, it might be necessary to adjust immunosuppressants and allow the immune system to recover. It’s a lot harder to treat the disease in an AIDS patient whose immune system is severely compromised, so antiretroviral therapy is commonly used by patients to restore immunity. Radiation and chemotherapy are also treatment options.


Vascular tumors are growths that develop in blood vessels or lymphatic vessels. These tumors can be benign or malignant. The most common types of benign vascular tumors are hemangiomas, which typically form in infancy and childhood and often resolve on their own over time. Malignant vascular tumors include angiosarcomas, which can occur in any part of the body, and Kaposi's sarcoma, which is typically seen in people with weakened immune systems, such as those with HIV/AIDS. Treatment for vascular tumors depends on the type, location, and size of the tumor, as well as the overall health of the individual. Options may include surgery, radiation therapy, chemotherapy, or a combination of these approaches.


  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. "Kaposi Sarcoma" Archives of Pathology &amp; Laboratory Medicine (2013)
  5. "Hemangioendothelioma" Seminars in Diagnostic Pathology (2013)
  6. "Angiosarcoma: clinical and imaging features from head to toe" The British Journal of Radiology (2017)

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