Intra-Axial Metastatic Angiosarcoma of the Central Nervous System Associated with Anemia, Pulmonary Tuberculosis and Short Survival
Arq. bras. neurocir; 39 (3), 2020
Publication year: 2020
Introduction Angiosarcoma (AG) is a malignant mesenchymal neoplasm that predominantly
affects the soft tissues and, to variable degrees, expresses themorphological
and functional characteristics of the endothelium. The incidence of sarcomas of the
central nervous system(CNS) is low (0.5% to 2.7%), and AGs involving the brain are even
rarer.
Case Description A 45-year-old male patient presented with complaints of headache,
nausea, and vomiting. An examination showed bilateral papilledema and a right lung
pleurotomy. The patient’s previous history included drug addiction, pulmonary
tuberculosis, lung abscess, pleural empyema, and pulmonary artery embolization
for severe hemoptysis. Computed tomography/magnetic resonance imaging scans
revealed a large intra-axial lesion extending into the right parietal and temporal lobes,
with hemorrhagic zones. The patient underwent surgical resection of the lesion.
Microscopy showed a poorly-differentiated, high-grade malignant tumor composed of
plump/epithelioid cells forming small vascular spaces and solid nests, compatible with
AG.In the postoperative period, the patient developed recurrent hemoptysis. A biopsy
of the tissues adjacent to the pleurotomy determined the diagnosis of pulmonary AG.
At 30 days after the resection, the patient died from hemoptysis, hemothorax, lung
atelectasis, and intracranial hypertension related to the recurrence of the brain tumor.
Conclusion Angiosarcoma is a rare neoplasia related to short survival due to the high
proliferative index, which must be considered in patients presenting hemorrhagic
tumors. No specific genetic abnormalities have been described for this neoplasia.
Hemangiosarcoma/diagnóstico por imagen, Hemangiosarcoma/fisiopatología, Hemangiosarcoma/cirugía, Hemangiosarcoma/complicaciones, Neoplasias del Sistema Nervioso Central/diagnóstico, Anemia, Tuberculosis Pulmonar/etiología, Pronóstico, Neoplasias de los Tejidos Blandos/diagnóstico, Metástasis de la Neoplasia