Bone and Soft-Tissue Disorders
= aggressive vascular malignancy, frequently with local recurrence + distant metastases; M÷F = 2÷1
Origin: endothelial + mesenchymal cells
Histo: vascular channels surrounded by hemangiomatous / lymphomatous cellular elements with high degree of anaplasia
Associated with:Stewart-Treves syndrome
= angiosarcoma with chronic lymphedema developing in postmastectomy patients
Location: skin (33%); soft tissue (24%); bone (6%): tibia (23%), femur (18%), humerus (13%), pelvis (7%)
- Most commonly in right atrium >retroperitoneum (IVC)
- heterogeneously enhancing mass expanding involved vessel
DDx: hemangioendothelioma, hemangiopericytoma
Soft-Tissue Angiosarcoma
- Risk factors: chronic lymphedema, previous radiation therapy, foreign bodies, immunosuppression
- Associated with: NF1, Klippel-Trénaunay-Weber syndrome, Maffucci syndrome
- Age: any age; peak incidence in 7th decade
- MR:
- intermediate signal intensity on T1WI
- areas of high SI on T1WI ← hemorrhage
- high SI on T2WI (← tumor necrosis + methemoglobin)
- aggressive infiltration of adjacent tissue
- intratumoral low SI on all pulse sequences ← high flow
- intratumoral high SI on T2WI ← low flow
- contrast enhancement ± central areas of necrosis