Angiosarcoma is a malignant tumor of blood vessels. This rare cancerous growth can develop at any site, but most commonly it occurs in the blood vessels of skin, particularly the skin of scalp, face and neck. In rare cases angiosarcoma may develop in other areas of skin and sometimes in the deeper tissues, liver, spleen and heart. Predominantly the tumor develops in elderly people and more in men as compared to women.
The etiology of angiosarcoma is not clearly understood but several reports suggest its association with chronic lymphedema or past history of radiation treatment.Angiosarcoma is considered an aggressive malignant tumor with high recurrence rate. It has tendency to spread to other organs and tissues at quiet early stage. Although there are various treatment options available, the prognosis seems to be poor. Standard treatment consists of multimodality approach such as excision of the tumor followed by radiation therapy.
Causes And Risk Factors Of Angiosarcoma
The exact cause of angiosarcoma is not clearly understood. Researchers know that something goes wrong in the cells of inner lining of the blood vessel. This abnormality may develop as a result of mutation in the genes that code the cellular lining of blood vessel.Exactly which gene is involved is yet known. Mutation causes increased growth of abnormal cells.
Constant multiplication of the abnormal cells will lead to formation of a mass or tumor of this cell. The abnormal cellular mass now has its own blood supply and grows relentlessly on its own. After a period of time, the cells from this growth will break and pass on to other sites of the body to develop a tumor. This process is called metastasis.
Risk factors of angiosarcoma are as follows:
- Lymphedema: Lymphedema is accumulation of lymph fluid when the lymph channel gets blocked. Lymphedema occurs when the lymph nodes are removed during surgery. Usually lymph nodes are removed during surgery in cancer treatment.
- Radiation: Exposure to radiation or radiation treatment.
- Exposure to chemicals: Person frequently exposed to chemicals and metals such as vinyl chloride and arsenic are at greater risk of suffering from angiosarcoma.
Signs And Symptoms Of Angiosarcoma
Angiosarcoma mainly occurs in skin of head, face and neck. It may sometimes develop in the breast skin or in deeper tissues and liver. The signs and symptoms of angiosarcoma thus may not be the same. They may depend on the site of its involvement. For example when it affects the skin the signs and symptoms it produces are as follows:
- A purple or violet bump on skin surface.
- The bump which appears similar to bruise may not heal but grow over a period of time.
- Mild rubbing or scratching can cause bleeding from the lesion.
- It may occur at the site of previous radiation therapy.
If angiosarcoma is deep seated in the tissue it may not present with any symptom until the tumor cells have spread to nearby or distant tissues. If angiosarcoma is present in liver or heart the growing tumor may produce pain in the affected region.
Diagnosis And Treatment Of Angiosarcoma
Following are the procedures that will help to diagnose angiosarcoma.
- Physical examination: The physician will examine the patient and take his medical history.
- Biopsy: A fine needle biopsy or removing a small piece of growth for histopathology test in a laboratory.
- Imaging: MRI, CT scan and PET scan may be needed to know the extent of growth and its spread.
The usual treatment of angiosarcoma is surgery. Once the diagnosis is confirmed with the help of biopsy, the treatment choice is to incise the tumor and nearby surrounding tissue. Surgery may depend on the size of tumor, its spread and grade of tumor. It may also depend in the general health of the patient.
In some cases where the tumor has spread to another site surgery may not be an option. In such cases chemotherapy may be necessary to kill the cancer cells. Often after surgery, radiation therapy is recommended by the doctor where X-ray and proton beams are focused at the site of growth to kill the left of cancer cells. Radiation therapy is considered to be an adjuvant therapy.