What is Angiosarcoma?
Angiosarcoma is a type of cancer that affects the lining of our blood vessels. Since it originates from a blood vessel, it can appear anywhere in our body. A very notable, but rare and fatal Angiosarcoma occurrence is the Liver Angiosarcoma. Liver Angiosarcoma is commonly seen in people that are exposed to certain chemicals that are used to make plastics. The death rate for this type of sarcoma is high because this type of sarcoma does not produce symptoms until the tumors are advanced.
Angiosarcoma on the Chest
A. Epithelioid Angiosarcoma
It is a rare type of angiosarcoma that affects the endothelial cells and is commonly seen in deep soft tissues. It has a low prognosis. The tumor can be seen at the skin, but it is rare.
There are cases that epithelioid angiosarcoma can arise in the lungs. It can affect the normal functions of the lungs and can produce symptoms that can be similar to the symptoms of lung disorders like tuberculosis and other respiratory problems. This fact can also be applied to other organs of the body that is made up of soft tissues.
B. Hepatic Angiosarcoma
It is a tumor that is seen in the blood vessels of the liver. Although rare, it is very fatal and an aggressive malignancy. It is a lethal tumor that will decrease the patient’s life expectancy down to 6 to 7 months.
The liver is rich in blood vessels, this is because its function is to detoxify the blood, so once the tumor is discovered, it is too late for any surgical intervention. The death was caused by hemorrhagic shock due to internal bleeding from the liver’s blood vessels.
Angiosarcoma In the Liver
C. Cardiac Angiosarcoma
This is the rarest type of angiosarcoma, it has an incidence rate of less that 0.1% in angiosarcoma patients. The survival period is 6 months at best. Although rare, the tumor is very aggressive and traditional tumor therapy is not successful. Some doctors will say that a heart transplant will solve the condition, but most of the patients have systemic metastasis.
D. Cutaneous Angiosarcoma
This type of angiosarcoma affects the skin’s blood vessels. The lesion is superficial and can present symptoms that is similar with other skin conditions. This is the reason that early consultations commonly result to misdiagnosis.
Doctors will order treatments that will treat the symptom, but not the angiosarcoma, and after a series of treatments for the lesion, it will get worse and a second diagnosis will be made. Commonly it will be the correct diagnosis of cutaneous sarcoma. Metastasis is common in this type of angiosarcoma.
Angiosarcoma on the face Mimicking Other Skin Conditions
Signs and Symptoms of Angiosarcoma
This condition does not have symptoms in its early stages, in this case, this condition is diagnosed after the appearance of the symptoms. I have listed down the symptoms of Leiomyosarcoma.
- Limited Range of Motion – This is possible if the tumor grows close in a joint. This will impede the range of motion of that joint because the tumor will obstruct the area of function of that joint.
- Pathologic Fracture – This can be present when the Angiosarcoma is located in the bones.
- Lump – In some cases, the tumor will be visible. This is a case where the tumor is superficial.
- Pain – Pain can be present at the site of tumor, but please note that this is not a definitive symptom because this can be caused by many other medical conditions.
Causes and Risk Factors of Angiosarcoma
Since Angiosarcoma does not present itself until they are matured, it is very difficult to trace the causes and the risk factors that can be associated with this condition. A thorough history taking should be done.
- Toxic Chemicals – Chemicals such as arsenic and vinyl are the most common chemicals that induce many types of cancers, people who have excessive exposure to these chemicals needs to consult their doctors.
- Radiation – Radiation can cause mutations to our normal body cells, this mutation can be a cause of many types of cancers.
- Existing Medical Condition – Presence of long-term Lymphedema is associated with Angiosarcoma.
- AIDS – There is significant relationship between Acquired Immunodeficiency Syndrome and Angiosarcoma.
- Existing Tumors – Angiosarcoma may arise at a previous benign tumors.
Staging of Angiosarcoma
- Stage I: Localized and resectable tumor is found in 1 location of the liver and could be treated surgically.
- Stage II: Localized and possibly resectable primary tumor is found in 1 or more locations in the organ and may be treated surgically. The decision to treat the disease surgically depends on the experience of the physician.
- Stage III: Advanced cancer has spread to more than 1 location in the organ and/or to other parts of the body. Frequently these tumors require multiple treatment modalities for maximum benefit. Often, surgical resection does not provide benefit to the patient.
- Stage IV: Disseminated cancer involves multiple sites throughout the body. Frequently, surgery is not indicated, and chemotherapy is the best option.
Diagnosis of Angiosarcoma
As we have talked about earlier, the symptoms of Angiosarcoma appears if the tumor that is caused is already mature. In this case, we do not have much time to intervene with the condition that is why Angiosarcoma, in any part of our body, is very dangerous.
Symptoms can be seen at the terminal stage of the tumor where we do not have much time left. However, if we can still can diagnose Angiosarcoma, these are the tests and exams that are performed to rule out this condition.
- X-ray – This is an initial diagnostic test to see the basic structure of the tumor.
- Bone Scan – This procedure is only done when the affected part of Angiosarcoma is in the bones. This is like an x-ray, but this procedure will provide us with more details than X-ray because it can reveal the abnormal portion of the bone.
- Advanced Imaging Tests – This includes MRI and CT Scan of the tumor, they are both specialized imaging test that is used to scan the tumor deeper with cross sectional view. Also, it can produce a detailed result on the status of the tumor. It can be used after the treatment to check if the treatment provided against the tumor is successful.
- Biopsy – Doctors will be extracting a sample specimen from the tumor and it will be used to diagnose the condition of the patient. Fine-needle biopsy is the most commonly used type of biopsy because of its accuracy and it does not leave a large wound on the patient.
Treatment of Angiosarcoma
This therapy is often used to destroy cancer cells locally. Although we can find it useless when it comes to tumors that exist deep in our body, we can still use it if the tumor can be reached by radiation without affecting normal cells.
This therapy is used to kill cancer cells systemically, this one is used for tumors that are not reached by radiation. This is very important in killing the remnant cancer cells after a surgery or a radiotherapy. This therapy is used simultaneously with Radiotherapy and Surgery for best results.
This is to remove the illness-causing tumor out of our body. Surgery cannot remove the cancer cells completely that is why in some cases, radiotherapy and chemotherapy is incorporated with surgery.
For better results, doctors have developed therapies that includes simultaneous use of radiation therapy and chemotherapy in combination with surgery. This combined therapy proved to be effective in treating Angiosarcoma. However, please remember that the overall treatment’s efficiency will depend on the extent of the malignancy. If it is diagnosed early, it can be treated without having complications.
Angiosarcomas often brings a high death rate because it is virtually not curable, and even if a patient survived, the patient will only have a short survival time. The disease is rare and uncommon, this is why there are limited research studies available to properly handle angiosarcoma. The studies shows that the survival time is 15 – 20 months. However, 35% of the patients can survive up to 5 years.
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