Metastatic Epithelioid Angiosarcoma of the Spine, Hip, and Femur

Eman EL-Sawalhy^1, , Muna Shaaeli¹, Wehbi Hnayni¹, Lubna Alattia² and Shahina Patel³

¹Department of Internal Medicine, Beaumont Hospital, Dearborn, MI

²Department of Clinical Pathology, Beaumont Hospital, Royal Oak, MI

³Division of Hematology & Oncology, Internal Medicine Department, Beaumont Hospital, Dearborn, MI

Cite this paper

Eman EL-Sawalhy, Muna Shaaeli, Wehbi Hnayni, Lubna Alattia and Shahina Patel. Metastatic Epithelioid Angiosarcoma of the Spine, Hip, and Femur. American Journal of Medical Case Reports. 2021; 9(7):345-347. doi: 10.12691/AJMCR-9-7-1

Abstract

Epithelioid Angiosarcoma (EA) is an extremely rare and highly aggressive malignant tumor. It comprises <1 % of all soft tissue sarcomas and is associated with a poor prognosis. In this case report, we are reporting an 85-years-old male who presented with lower back and left hip pain. A computerized tomography (CT) of the lumbar spine and left hip showed a significant fracture of lumbar spine L3 and osteolytic lesions involving the left hip and femur. The patient underwent L1-L5 fusion with cement augmentation and biopsy of L3. Surgical pathology showed a metastatic undifferentiated tumor of unknown primary origin. Histologic analysis of the specimen and immunohistochemistry confirmed EA. Given extensive diffuse bone involvement, our patient was not a candidate for definitive surgical treatment.

Keywords

Epithelioid Angiosarcoma, bone, surgical resection, Tazemetostat

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]	Yuanzhou He, Ying Zhou, Min Xie, Xiansheng Liu. Epitheloid angiosarcoma of the mediastinum: a case report and literature review. Int J Clin Exp Med 2019; 12(7): 9478-9482.
[2]	Houda Boucekkine, BS, David Ying, MD Primary Epitheloid Angiosarcoma of the Femur and Tibia: A rapidly Aggressive Course. AMSRJ. Miami. 201.
[3]	Hart J, Mandavilli S. Epithelioid angiosarcoma: a brief diagnostic review and differential diagnosis. Arch Pathol Lab Med. 2011 Feb; 135(2): 268-72.
[4]	Sakamoto A, Takahashi Y, Oda Y, Iwamoto Y. Aggressive clinical course of epithelioid angiosarcoma in the femur: a case report. World J Surg Oncol. 2014; 12: 281. Published 2014 Sep 11.
[5]	Mrinal Gounder, Patrick Schöffski, Robin L Jones, Mark Agulnik, Gregory M Cote, Victor M Villalobos, Steven Attia, Rashmi Chugh, Tom Wei-Wu Chen, Thierry Jahan, Elizabeth T Loggers, Abha Gupta, Antoine Italiano, George D Demetri, Ravin Ratan, Lara E Davis, Olivier Mir, Palma Dileo, Brian A Van Tine, Joseph G Pressey, Trupti Lingaraj, Anand Rajarethinam, Laura Sierra, Shefali Agarwal, Silvia Stacchiotti. Tazemetostat in advanced epithelioid sarcoma with loss of INI1/SMARCB1: an international, open-label, phase 2 basket study.Lancet Oncol.Vol 21 November 2020.
[6]	Young RJ, Brown NJ, Reed MW, Hughes D, Woll PJ. Angiosarcoma. Lancet Oncol. 2010; 11: 983-991.