Angiosarcoma (bone)

Last revised by Henry Knipe on 8 Jul 2023

Angiosarcoma of bone is a malignant vascular bone tumor. These are rare and account for <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 chronic dull pain and/or tumor mass. Other presentations include:

Angiosarcomas can be unifocal or multifocal, with one study citing that up to one-third can be multifocal 4. The most common sites are short and long tubular bones of extremities 2:

  • femur: 23%

  • tibia: 18%

  • humerus: 13%

  • pelvis: 7%

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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