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Visceral and Nonvisceral Angiosarcomas: Imaging Features and Clinical Correlation

This paper is available in a repository.
This paper is available in a repository.

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Abstract

Angiosarcomas are highly malignant neoplasms of vascular origin. They most commonly arise from the skin and subcutaneous soft tissue of the head and neck, with only a small percentage of tumors from the viscera. In this article, we evaluated the clinical and imaging features of angiosarcomas and compared visceral angiosarcomas with nonvisceral angiosarcomas. A comparison between angiosarcomas and hemangiopericytomas was performed as well. This study included 14 patients (7 men, 7 women, averaging 53 years) with pathologically confirmed angiosarcomas during a period of 14 years. All clinical data and images, including computed tomography (CT) images in 10 patients and magnetic resonance images (MRI) in two, were reviewed. The clinical data of angiosarcomas in the present study were also compared with those of hemangiopericytomas from our previously reported study. Visceral and nonvisceral each comprised 50% of all angiosarcomas in the study. Visceral angiosarcomas were larger at the time of diagnosis than nonvisceral angiosarcomas. The metastatic rate was much higher for patients with visceral angiosarcomas than for those with nonvisceral angiosarcomas. The overall 2-year and 5-year survival rates were lower for patients with visceral angiosarcomas than for those with nonvisceral angiosarcomas. Most lesions were ill defined, heterogeneous, and had variable degrees and patterns of enhancement on contrast-enhanced CT images. The overall two-year survival rate for the patients with angiosarcomas and those with previously reported hemangiopericytomas were 43% and 61 % respectively. Angiosarcomas were heterogeneously hypointense on T1-weighted MR images and hyperintense on T2-weighted MR images. In our report, visceral angiosarcomas were more common, had higher metastatic rates, and poorer prognosis than nonvisceral angiosarcomas. Imaging features were nonspecific to angiosarcomas but were characteristic for hypervascular tumors. The prognosis for patients with hemangiopericytomas was poorer than for those with nonvisceral angiosarcomas, but better than for those with visceral angiosarcomas.