Aortic Angiosarcoma Manifesting as Multiple Musculoskeletal Metastases: A Case Report.
Won Jong BahkSae Jung NaIn Yong WhangYongju KimKyung-Jin SeoPublished in: Diagnostics (Basel, Switzerland) (2024)
Aortic angiosarcomas are rare. Due to its rarity and metastatic presentation, it is difficult to diagnose metastatic aortic angiosarcoma. We describe the clinicopathological and radiologic features of a metastatic aortic angiosarcoma presenting as musculoskeletal metastases. A 59-year-old male patient presented with left thigh pain. Plain radiographs revealed multifocal osteolytic lesions in the left femur shaft. Abdominopelvic computed tomography showed a lobulated osteolytic lesion in the left iliac bone. Magnetic resonance images revealed multifocal soft tissue lesions in the thigh musculature. A positron emission tomography/computed tomography (PET/CT) scan demonstrated multiple foci of increased uptake in the left femur bone, pelvis, left thigh, and calf musculature. Focal increased uptake in the lower abdominal aorta was newly detected. Pelvis biopsy showed tumor cell nests of epithelioid cells. The tumor cells showed vasoformative features. Immunohistochemically, the tumor cells showed positivity for vimentin, CD31, and ERG. The pathologic diagnosis of epithelioid angiosarcoma was established. The origin of the tumor was presumed to be the aorta. This case underscores the importance of PET scans in identifying primary lesions. In terms of the histopathologic diagnosis of biopsy samples with tumor cells exhibiting epithelioid neoplastic morphology, employing appropriate ancillary techniques such as immunocytochemistry with vascular markers may assist in accurately diagnosing metastatic angiosarcoma.
Keyphrases
- positron emission tomography
- computed tomography
- soft tissue
- aortic valve
- pet ct
- pulmonary artery
- squamous cell carcinoma
- small cell lung cancer
- aortic dissection
- bone mineral density
- magnetic resonance
- left ventricular
- contrast enhanced
- dual energy
- magnetic resonance imaging
- single cell
- pet imaging
- induced apoptosis
- pulmonary hypertension
- ultrasound guided
- case report
- pulmonary arterial hypertension
- image quality
- fine needle aspiration
- chronic pain
- endoplasmic reticulum stress
- body composition
- optical coherence tomography
- convolutional neural network
- cell therapy
- radiation therapy
- bone loss
- cell cycle arrest
- mesenchymal stem cells
- spinal cord
- lymph node
- cell proliferation
- rectal cancer
- cell death
- oxidative stress