A rare case of epithelioid angiosarcoma

Authors

  • Ana Margarida Correia Surgical Oncology Department, Instituto Português de Oncologia do Porto Francisco Gentil (IPO-Porto), Porto, Portugal https://orcid.org/0000-0003-0112-7401
  • Rafael Ribas Fernandes General Surgery Department, Hospital das Forças Armadas – Pólo do Porto, Portugal https://orcid.org/0000-0001-6469-5401
  • José Carlos Vidoedo Vascular Surgery Department, Centro Hospitalar do Tâmega e Sousa, Penafiel, Portugal https://orcid.org/0000-0002-5061-4145
  • Jorge Guimarães Surgical Oncology Department, Instituto Português de Oncologia do Porto Francisco Gentil (IPO-Porto), Porto, Portugal
  • João Almeida Pinto Vascular Surgery Department, Centro Hospitalar do Tâmega e Sousa, Penafiel, Portugal https://orcid.org/0000-0001-6519-6591

DOI:

https://doi.org/10.48729/pjctvs.301

Keywords:

Surgical Oncology, Vascular surgery, Diagnosis, Differential, Angiosarcoma

Abstract

Epithelioid angiosarcoma is a rare high-grade vascular neoplasm with a poor prognosis.

We present an anticoagulated 77-year-old man, with a history of popliteal/soleal vein thrombosis in the previous month, complaining of ipsilateral persistent lower limb pain and claudication. Absent popliteal/distal pulses prompted an arterial doppler ultrasound (DUS), revealing thrombosis of the distal superficial femoral artery and a popliteal mass. As the arterial wall’s integrity could not be appropriately evaluated by DUS, adventitial cystic disease of the popliteal artery was suspected. Computed tomography angiography and magnetic resonance imaging findings were also suggestive. Due to refractory pain, he was submitted to a popliteal mass excision along with a femoral-posterior tibial bypass. Pathology revealed an epithelioid angiosarcoma. He was referred to a Sarcoma Center, requiring hospitalization for agitation and fever. A positron emission tomography (PET) scan revealed extensive lower limb disease persistence and distant metastases. He died on the 56th day after surgery.

To our knowledge, there are only 15 cases of angiosarcoma of the popliteal artery described in the literature. Ours stands out as the first one unrelated to a popliteal aneurysm.

Being a highly-aggressive tumor, an early diagnosis is challenging but essential to a successful treatment, warranting the need for suspicion of this neoplasm. An early core biopsy or surgical sample may expedite the diagnosis.

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References

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Published

13-05-2024

How to Cite

1.
Correia AM, Ribas Fernandes R, Vidoedo JC, Guimarães J, Almeida Pinto J. A rare case of epithelioid angiosarcoma. Rev Port Cir Cardiotorac Vasc [Internet]. 2024 May 13 [cited 2024 May 21];31(1):47-51. Available from: https://pjctvs.com/index.php/journal/article/view/301

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