Late Presentation of Popliteal Angiosarcoma After Previously Treated Popliteal Artery Aneurysm

Angiosarcoma and Vascular Surgery: A Case Report and Review of Literature

“…Pain and weight loss were the most common symptoms, others include claudication, unexplained fever and fatigue. Probably because of the deep localization of the mass, only 3 patients presented cutaneous manifestations, always referred as painful; [16][17][18][19][20][21][22][23][24][25] specifically, in two patients AS presented as erythematous and violaceous papules and nodules and in one patient as skin ulceration and cellulitis. Primary cutaneous AS are rare; Kikuchi et al in a 2008 review, described only 15 cases reported in the literature from 1986.…”

“…16,25 The featureless clinical presentation could lead to a misdiagnosis, as seen in 2 cases, where the condition was considered an infection of the graft. 11,13 The incisional biopsy (performed in 7 cases) 6,8,9,14,22 or surgical excision (14 cases) 3,4,7,[10][11][12][13]15,17,[19][20][21]23,25 allowed a correct histopathological diagnosis.…”

“…Even if a complete resection of the mass represents the treatment of choice, chemotherapy, radiotherapy or both were proposed with an adjuvant or palliative purpose, in seven, 5,7,10,14,16,21,22 three 4,8,19 and four cases 14,20 respectively. In spite of treatment, the prognosis was generally poor: 18 patients died of the disease on average 4 months after the diagnosis, 3,[5][6][7][8][9][10][11][12][13]15,17,19,20,[22][23][24][25] 9 of them presenting metastasis. 3,[5][6][7]9,10,19,20,25…”

“…Including our patient, a total of 25 cases have been reported in the literature [Table 1]. 3-25 Most patients were males (21 men vs 4 women) with age ranging from 50 to 84 years (average age 68.3 ± 10.1 years). The overall mean time to onset after prior vascular surgery was 7.8 ± 5 years (from 3 months to 17 years).…”

“…Surgical procedures used different materials: 12 patients received a Dacron graft, 3-7,9,10,12,13,16,18,22 3 a poly-tetra-flour-ethylene (PTFE) graft, 15,21,23 5 received a transplantation of their own saphenous vein, 8,19,20,25 and in 5 cases the material used was not specified. 11,14,17,24 The most common reported symptoms were pain (20 cases) 3-5,7,8,10-12,14-21,23,25 and weight loss (10 cases). 5,7-12,14,16 Dermatological signs, such as painful erythematous and violaceous papules, plaques and nodules, skin ulceration and cellulitis, were observed in only 3 patients.…”