A rare case of angiosarcoma with skull masses and erythropenia and thrombocytopenia

Rationale: Primary splenic angiosarcoma (PSA) is a rare, fatal neoplasm originating from sinusoidal vascular endothelial cells, and usually metastasizes and almost always has a poor prognosis. Surgical excision is the main treatment of this highly malignant disease. Patient concerns: We reported a special case of a 68-year-old female who had a 6-month history of scalp masses. Diagnosis: The patient was found to have 2 skull masses on computed tomography (CT). Laboratory findings revealed erythropenia and thrombocytopenia. Enhanced abdomen magnetic resonance imaging (MRI) showed multiple masses in liver and spleen. The pathological result of the skull masses was revealed to be metastatic angiosarcoma. Interventions: The patient underwent surgical excision of skull masses, and no subsequent radiotherapy or chemotherapy was done. Outcomes: The patient died due to dyscrasia at August 12, 2015, with a survival of nearly 1 month. Lessons: We highlight the importance for clinicians to be aware of this rare neoplasm, and to consider it in the differential diagnosis when encountering a skull mass. Early confirmation and treatment may improve the prognosis.

[1]  R. Valsaraj,et al.  A CLINICAL STUDY OF CYTOPENIAS WITH SPECIAL REFERENCE TO MEGALOBLASTIC ANAEMIA IN A TERTIARY CARE CENTRE , 2016 .

[2]  A. Abdou,et al.  Primary Epithelioid Angiosarcoma of Spleen: A Case Report and Review of Literature. , 2016, Journal of clinical and diagnostic research : JCDR.

[3]  T. Hackman,et al.  Angiosarcoma of the Head and Neck , 2015, International Archives of Otorhinolaryngology.

[4]  T. Kusumi,et al.  [A case of angiosarcoma of the spleen with intraperitoneal bleeding]. , 2014, Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology.

[5]  S. Çifçi,et al.  Rectal Carcinoma Case Causing Bicytopenia , 2014, World journal of oncology.

[6]  Yong Jiang,et al.  Spontaneous rupture of primary splenic angiosarcoma: a case report and literature review , 2013, World Journal of Surgical Oncology.

[7]  P. Valent Low blood counts: immune mediated, idiopathic, or myelodysplasia. , 2012, Hematology. American Society of Hematology. Education Program.

[8]  R. Marwaha,et al.  Pediatric patients with bicytopenia/pancytopenia: review of etiologies and clinico-hematological profile at a tertiary center. , 2011, Indian journal of pathology & microbiology.

[9]  Jinsong Liu,et al.  Angiosarcoma of the spleen clinically presenting as metastatic ovarian cancer. A case report and review of the literature. , 2005, Annals of diagnostic pathology.

[10]  W. M. Thompson,et al.  Angiosarcoma of the spleen: imaging characteristics in 12 patients. , 2005, Radiology.

[11]  M. Paci,et al.  A Case of Metastatic Epithelioid Angiosarcoma in the Lamina Propria of a Sigmoid Tubulovillous Adenoma , 2005, Tumori.

[12]  Prof. Theodor Langhans Pulsirende cavernöse Geschwulst der Milz mit metastatischen Knoten in der Leber. Tödtlicher Verlauf binnen 5 Monaten , 1879, Archiv für pathologische Anatomie und Physiologie und für klinische Medicin.

[13]  W. M. Thompson,et al.  From the archives of the AFIP: primary vascular neoplasms of the spleen: radiologic-pathologic correlation. , 2004, Radiographics : a review publication of the Radiological Society of North America, Inc.

[14]  L. Křen,et al.  Primary angiosarcoma of the spleen in a child. , 2003, Medical and pediatric oncology.

[15]  L. Thompson,et al.  Splenic Angiosarcoma: A Clinicopathologic and Immunophenotypic Study of 28 Cases , 2000, Modern Pathology.

[16]  H. Fischer,et al.  [Littoral cell angiosarcoma of the spleen. Morphologic, immunohistochemical findings and consideration of histogenesis of a rare splenic tumor]. , 1997, Der Pathologe.

[17]  H. Fischer,et al.  Littoralzellangiosarkom der Milz Morphologische, immunhistochemische Befunde und Überlegungen zur Histogenese eines seltenen Milztumors , 1997, Der Pathologe.

[18]  J. Poen,et al.  Angiosarcoma: A report of 67 patients and a review of the literature , 1996, Cancer.

[19]  N. Naka,et al.  Prognostic factors in angiosarcoma: A multivariate analysis of 55 cases , 1996, Journal of surgical oncology.

[20]  J. Krishnan,et al.  Primary Angiosarcoma of the Spleen A Clinicopathologic Study of 40 Cases , 1993, The American journal of surgical pathology.

[21]  L. A. Marques,et al.  Soft‐tissue sarcomas of the head and neck in adults and children: Experience at a single institution with a review of literature , 1988, International journal of cancer.

[22]  D. Catovsky,et al.  Splenic angiosarcoma following chemotherapy for follicular lymphoma. , 1986, Human pathology.