Key Points
• For clinical classification purposes it suffices to recognize a benign (hemangioma) and malignant (angiosarcoma) side of the spectrum with hemangioendothelioma as a malignant intermediate form.
• A radiological diagnosis of angiosarcoma should be considered when multiple lesions are seen in one region.
• Histologically angiosarcoma looks like metastasis.
• A radiological suspicion for angiosarcoma should trigger the use of specific vascular markers by the pathologist.
• Angiosarcoma typically presents as an aggressive-looking osteolytic lesion, or lesions without periosteal reaction.
• Angiosarcma may present as a well-defined lesion with geographic destruction of bone, resembling fibrous dysplasia.
• Vertebral hemangiomas with a marked vascular component, as opposed to a marked fatty component, may cause severe symptoms.
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References
Aoki M, Batista O, Bellacosa A, Tsichlis P, Vogt PK (1998) The akt kinase: molecular determinants of oncogenicity. Proc Natl Acad Sci USA 95:14950−14955
Campanacci M, Boriani S, Giunti A (1980) Hemangioendothelioma of bone: a study of 29 cases. Cancer 46:804−814
Chang HW, Aoki M, Fruman D, Auger KR, Bellacosa A, Tsichlis PN, Cantley LC, Roberts TM, Vogt PK (1997) Transformation of chicken cells by the gene encoding the catalytic subunit of PI 3-kinase. Science 276:1848−1850
Chasi I, Hide G (2008) Hemangioma, bone. E-medicine, vol. 322
Evans HL, Raymond AK, Ayala AG (2003) Vascular tumors of bone: a study of 17 cases other than ordinary hemangioma, with an evaluation of the relationship of hemangioendothelioma of bone to epithelioid hemangioma, epithelioid hemangioendothelioma, and high-grade angiosarcoma. Hum Pathol 34:680−689
Laredo JD, Assouline E, Gelbert F, Wybier M, Merland JJ, Tubiana JM (1990) Vertebral hemangiomas: fat content as a sign of aggressiveness. Radiology 177:467−472
Larsson SE, Lorentzon R, Boquist L (1975) Malignant hemangioendothelioma of bone. J Bone Joint Surg Am 57:84−89
Lomasney LM, Martinez S, Demos TC, Harrelson JM (1996) Multifocal vascular lesions of bone: imaging characteristics. Skeletal Radiol 25:255−261
Maclean FM, Schatz J, McCarthy SW, Scolyer RA, Stalley P, Bonar SF (2007) Epithelioid and spindle cell haemangioma of bone. Skeletal Radiol 36 (Suppl 1):S50−S57
Mulder JD, Schütte HE, Kroon HM, Taconis WK (Netherlands Committee on Bone Tumors) (1993) The diagnosis of bone tumor. In: Radiologic atlas of bone tumors. Elsevier, Amsterdam, pp 9−16
O’Connell JX, Nielsen GP, Rosenberg AE (2001) Epithelioid vascular tumors of bone: a review and proposal of a classification scheme. Adv Anat Pathol 8:74−82
O’Reilly MS, Boehm T, Shing Y, Fukai N, Vasios G, Lane WS, Flynn E, Birkhead JR, Olsen BR, Folkman J (1997) Endostatin: an endogenous inhibitor of angiogenesis and tumor growth. Cell 88:277−285
Paik JH, Kollipara R, Chu G, Ji H, Xiao Y, Ding Z, Miao L, Tothova Z, Horner JW, Carrasco DR, Jiang S, Gilliland DG, Chin L, Wong WH, Castrillon DH, DePinho RA (2007) FoxOs are lineage-restricted redundant tumor suppressors and regulate endothelial cell homeostasis. Cell 128:309−323
Resnick D, Kyriakos M, Greenway GD (2002) Tumors and tumor-like lesions of bone: imaging and pathology of specific lesions. In: Resnick D (ed) Diagnosis of bone and joint disorders, 4th edn. Saunders, Philadelphia, pp 3983−3985
Roessner A, Boehling T (2002) Angiosarcoma. In: Fletcher C, Unni K, Mertens F (eds) Pathology and genetics of tumours of soft tissue and bone. IAC Press, Lyon, pp 322−323
Wenger DE, Wold LE (2000a) Benign vascular lesions of bone: radiologic and pathologic features. Skeletal Radiol 29:63−74
Wenger DE, Wold LE (2000b) Malignant vascular lesions of bone: radiologic and pathologic features. Skeletal Radiol 29:619−631
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Suhardja, A., Verbeke, S., Bloem, J. (2009). Angiomatous Neoplasms of the Skeletal System. In: Davies, A., Sundaram, M., James, S. (eds) Imaging of Bone Tumors and Tumor-Like Lesions. Medical Radiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-77984-1_19
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