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Angiosarcoma - bone

Last revised by Dr Daniel J Bell on 18 Dec 2019

Angiosarcoma of bone is a malignant vascular tumor of bone. These are rare and account for less than 1% of malignant bone tumors. The majority of these tumors arising in bone are primary; however, a tiny percentage are either radiation-induced or associated with bone infarction

Most common in young individuals. Males are more commonly affected than females. 

Although there is no particular clinical presentation, the majority of the patients present with a chronic dull pain and/or tumor mass. Other presentations include

  • associated neurological deficits
  • pathological fractures - rare
  • most common sites are short and long tubular bones of extremities 2
    • femur - 23%
    • tibia - 18%
    • humerus - 13%
    • pelvis - 7%

Angiosarcomas can be unifocal or multifocal, with one study citing that up to one-third can be multifocal 4.

They are usually purely lytic, eccentric and occur in a metadiaphyseal location. They can have a very aggressive appearance, without a periosteal reaction and less soft tissue extension. 

Can occur as multiple lesions in same bone. 

Metastatic lesions to other skeletal sites may be seen.

In general very poor prognosis and depends on location and extent. Treatment options include:

  • wide surgical excision 
  • limb-sparing surgery
  • radiotherapy

Possible differential considerations include:

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