Epithelioid angiosarcoma of the bone: A series of 10 cases

Vikram Deshpande, Andrew Rosenberg, John X. O'Connell, G. Petur Nielsen

Research output: Contribution to journalArticle

60 Citations (Scopus)

Abstract

The clinical and pathologic features of 10 epithelioid angiosarcomas of bone were analyzed. There were eight males and two females who ranged in age from 26 to 83 years (mean 62 years). Four tumors were solitary and six were multifocal. In two consultation cases, the submitted diagnosis was metastatic carcinoma. Microscopically, the tumor cells were arranged in solid and infiltrative sheets, and in most cases vascular channels or cystically dilated spaces were present. The neoplastic cells had abundant eosinophilic cytoplasm and large nuclei with open chromatin and prominent eosinophilic nucleoli. Intratumoral hemorrhage, neutrophilic infiltrates, and intracytoplasmic lumina were frequently present. All 10 tumors stained positive for one or more endothelial markers, with CD31 being the most sensitive marker. Seven cases stained positive for cytokeratin. Ultrastructural examination in three tumors confirmed their endothelial differentiation. In the absence of obvious vascular differentiation, abundant intratumoral hemorrhage and intratumoral neutrophils are useful ancillary morphologic features that may suggest a vascular origin. Six patients are dead of disease, one is alive with metastasis, and two patients are currently disease free. Epithelioid angiosarcoma of bone should be included in the differential diagnosis of epithelioid neoplasms of bone, and endothelial markers should be a part of their immunohistochemical analysis to avoid the misdiagnosis of a metastatic carcinoma because of the significant differences in the treatment and clinical outcomes of these entities.

Original languageEnglish
Pages (from-to)709-716
Number of pages8
JournalAmerican Journal of Surgical Pathology
Volume27
Issue number6
DOIs
StatePublished - Jun 1 2003
Externally publishedYes

Fingerprint

Hemangiosarcoma
Blood Vessels
Bone and Bones
Neoplasms
Hemorrhage
Carcinoma
Bone Neoplasms
Keratins
Diagnostic Errors
Chromatin
Cytoplasm
Neutrophils
Differential Diagnosis
Referral and Consultation
Neoplasm Metastasis

Keywords

  • Bone neoplasms
  • Epithelioid angiosarcoma

ASJC Scopus subject areas

  • Anatomy
  • Pathology and Forensic Medicine

Cite this

Epithelioid angiosarcoma of the bone : A series of 10 cases. / Deshpande, Vikram; Rosenberg, Andrew; O'Connell, John X.; Nielsen, G. Petur.

In: American Journal of Surgical Pathology, Vol. 27, No. 6, 01.06.2003, p. 709-716.

Research output: Contribution to journalArticle

Deshpande, Vikram ; Rosenberg, Andrew ; O'Connell, John X. ; Nielsen, G. Petur. / Epithelioid angiosarcoma of the bone : A series of 10 cases. In: American Journal of Surgical Pathology. 2003 ; Vol. 27, No. 6. pp. 709-716.
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