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Two patients with metastatic angiosarcoma of the brain are described. In one, a 17-year-old man, the tumor was located at the pineal region and exhibited significant vascularity. It was sensitive to radiation therapy and disappeared after radiation of 50 Gy; however, it recurred after 1 year and a new lesion was found in the liver. The other patient is a 31-year-old woman who experienced sudden onset of headache. Computed tomography scan revealed three separate masses in the brain. One tumor was surgically removed. The other two were sensitive to radiation therapy and disappeared after radiation of 40 Gy. A new lesion was found in the femur 16 months after the operation. Brain metastasis from angiosarcoma is exceedingly rare. Both patients developed symptoms with intracranial hemorrhage. The diagnosis of the metastatic lesions preceded diagnosis of the primary lesion by 12 and 16 months, respectively. Ulex europaeus 1 lectin and factor VIII were very useful in establishing the diagnosis of angiosarcoma.
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PMID:Metastatic angiosarcoma of the brain. 190 Nov 78

Angiosarcoma is a rare malignant tumor originating from vascular endothelial cells. We have experienced a case of 17-year-old man, who had angiosarcoma in the pineal region and the liver. Patient's initial symptom was headache and CT scan revealed a high density mass in the pineal region with obstructive hydrocephalus. After the radiation therapy, the tumor was disappeared completely on CT scan. One year later, he developed abdominal pain, and CT scan and angiogram revealed multiple angioma like lesions in the liver. The mass in the pineal region showed concomitant regrowth, and finally, the patient was died of abdominal hemorrhage. At autopsy, pineal tumor and hepatic tumor were both angiosarcomas, although it was uncertain which was the original tumor.
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PMID:[Angiosarcoma of the liver and pineal region]. 338 82

A 30-year-old man who died from brain metastasis of cardiac angiosarcoma is presented. His chest X-ray film showed cardiac tamponade and bilateral pleural effusion. His symptoms were improved only by drainage of the bloody pericardial and pleural effusion. During the course of the disease, multiple nodular infiltrates were seen on chest CT and hemoptysis occurred repeatedly. He presented to our hospital. On the first night of hospitalization, symptoms including headache, vomiting and disturbance of consciousness appeared and brain CT showed suspected brain metastasis. He died on the 20th hospital day with no definite diagnosis having been established. At postmortem examination, a hen's egg sized cardiac angiosarcoma was found infiltrating the right atrial wall. Metastatic foci were found in the epicardium and bilateral lungs. This case was considered to be angiosarcoma of the heart, manifesting various clinical symptoms because of bleeding from the metastatic foci.
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PMID:[A case of angiosarcoma of the heart with cardiac tamponade and repeated hemoptysis]. 827 23

Bacillary angiomatosis is known to be caused by a rickettsial organism; Rochalimaea henselae. This causative agent has been compared with different microorganisms and clinical conditions that appear in similar settings buy have been clearly differentiated from them; e.i. Cat-scratch disease (Afipia felis), Bartonella bacilliformis, other Rochalimaea sp., Kaposi's sarcoma, Lobular capillary hemangioma, Angiosarcoma, and Epithelioid hemangioma. Clinically the bacillary angiomatosis (BA) skin lesions vary from a single lesion to thousands. The cutaneous lesion appears as a bright-red round papule, subcutaneous nodule, or as a cellulitic plaque. When the lesion is biopsied it tends to blanch-out, bleed, and cause pain. The patient might present with signs and symptoms of chills, headaches, fever, malaise, and anorexia with or without weight loss. The extracutaneous lesions found in BA tend to be from multiple organs affecting from the oral lesions to anal mucosal lesions to widespread visceral lesions. The sites of preference for BA lesion manifestation tend to be the liver, spleen, lymph nodes, and bone. To diagnose bacillary angiomatosis the physician should prepare a differential diagnosis based primarily on its histopathological and clinical characteristics. To confirm the results from the stain, electron microscopy can identify the bacillus and pin-point the diagnosis of bacillary angiomatosis. The lesions presented by BA respond well to therapy with erythromycin 500 mg four times daily for a duration of 2 weeks to 2 months. In case of intolerance to erythromycin the second line of drug that successfully treats the BA bacillus is doxycyline. If relapses of the BA lesion recur, then a prolonged antibiotic therapy is necessary and in AIDS patients the duration may be extended as life-long suppressive therapy.
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PMID:Bacillary angiomatosis: microbiology, histopathology, clinical presentation, diagnosis and management. 870 69

Bacillary angiomatosis is known to be caused by a rickettsial organism; Rochalimaea henselae. This causative agent has been compared with different microorganisms and clinical conditions that appear in similar settings but that have been clearly differentiated from them; e.i. Cat-scratch disease (Afipia felis), Bartonella bacilliformis, other Rochalimaea sp., Kaposi;s sarcoma, Lobular capillary hemangioma, Angiosarcoma, and Epithelioid hemangioma. Clinically the bacillary angiomatosis (BA) skin lesions vary from a single lesion to thousands. The cutaneous lesion appears as a bright-red round papule, subcutaneous nodule, or as a cellulitic plaque. When the lesion is biopsied it tends to blanch-out, bleed, and cause pain. The patient might present with signs and symptoms of chills, headaches, fever, malaise, and anorexia with or without weight loss. The extracutaneous lesions found in BA tend to be from multiple organs affecting from the oral lesions to anal mucosal lesions to widespread visceral lesions. The sites of preferences for BA lesion manifestation tend to be the liver, spleen, lymph nodes, and bone. To diagnose bacillary angiomatosis the physician should prepare a differential diagnosis based primarily on its histopathological and clinical characteristics. To confirm the results from the stain, electron microscopy can identify the bacillus and pin-point the diagnosis of bacillary angiomatosis. The lesions presented by BA respond well to therapy with erythromycin 500mg four times daily for a duration of 2 weeks to 2 months. In case of intolerance to erythromycin the second line of drug that successfully treats the BA bacillus is doxycycline. If relapses of the BA lesion recur, then a prolonged antibiotic therapy is necessary and in AIDS patients the duration may be extended as life-long suppressive therapy.
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PMID:Bacillary angiomatosis: microbiology, histopathology, clinical presentation, diagnosis and management. 891 40

Bacillary angiomatosis (BA) is an infectious disease characterized by proliferative vascular lesions; it mainly affects HIV-positive patients. Multiple cutaneous nodular lesions together with fever, chills, malaise, anorexia, vomiting and headache are the most important clinical manifestations. It may also involve the heart, liver, spleen, bones, lung, muscles, lymph nodes, central nervous system and other organs. Erythromycin, 500 mg four times a day, is the drug of choice. The importance of this lesion lies in its clinical and histological similarity with other diseases. Cutaneous and oral lesions of BA clinically resemble Kaposi's sarcoma (KS). Histopathologically, BA may be confused with angiosarcoma, pyogenic granuloma and epithelioid hemangioma. We report two HIV-positive men with BA lesions in the oral mucosa. Diagnosis was confirmed by biopsy and Warthin-Starry silver staining.
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PMID:Bacillary angiomatosis affecting the oral cavity. Report of two cases and review. 1071 5

The purpose of this article is to describe the clinical and pathological features of metastatic angiosarcoma in the central nervous system. Only a few cases of cerebral metastasis from angiosarcoma of the heart have been recorded in the literature; particularly related to intracerebral hemorrhage. A case of secondary cerebral angiosarcoma of the heart in a 33 years old man is presented. The initial symptoms were headache, vomiting, lethargy and aphasia. There was a mass in the left temporal lobe with hemorrhage and edema on the computerized tomography (CT). After 24 hours the neurological status worsened and another CT scan showed rebleeding on the tumor area. He underwent an emergency craniotomy but died two days after. Considering the longer survival of sarcoma patients with new modalities of treatment, the incidence of brain metastasis may increase, demanding a better preventive and more aggressive approach. Besides, due to the hemorrhagic nature of such lesions, we suggest the immediate surgery to prevent a fast and lethal evolution because rebleeding.
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PMID:Hemorrhage in cerebral metastasis from angiosarcoma of the heart: case report. 1159 85

Sarcomas constitute 5% of all of head and neck neoplasms. Angiosarcomas comprise 2% of all soft tissue tumors, 60% appear in skin and soft tissue, 50% in the head and neck and only 4% are present in the upper aerodigestive tract. We report a case of a 52 year old healthy woman with headache, weeping, foreign body sensation in the left nostril and epixtasis. The TAC identified a tumor in the left nostril that invaded the osseous lamina of the skull. The histopathologic diagnosis was angiosarcoma. We carried out a literature review and analysis from 1976 to 2004. Agiosarcomas of the upper aerodigestive tract have a better prognosis and long term survival free of disease than their soft tissue and skin counterparts. Recurrence is strongly correlated with positive resection margins. Complete surgery and radiotherapy are considered the optimal treatment schemes.
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PMID:[Nasal cavity angiosarcoma: a case report and literature review]. 1671 50

Primary intracranial angiosarcomas are rare. Only a few cases have been reported in the literature. All cases reported were located in the supratentorial areas. To our knowledge, no cerebellopontine (CP) angle angiosarcoma has been reported. We report a 16-year-old girl who had mild headache, right-sided tinnitus and amblyacousia of 1-year's duration. She later developed abruptly severe headache and vomiting, accompanied by left hemiparesis, numbness, ataxia and bucking, and computerized tomography scan and magnetic resonance imaging were performed. There was a lesion in the right CP angle with haemorrhage and edema. The preoperative diagnosis was neurogenic tumor with haemorrhage. The patient underwent an emergency suboccipital craniectomy, and the lesion was excised completely. Histopathology and immunohistochemistry revealed an angiosarcoma. Postoperative radiotherapy was given. At the time of hospital discharge, she was in better clinical and neurological condition than her preoperative state. She has been followed up for 6 months and is is still in excellent condition without any sign of recurrence. This case report highlights that clinicians should be aware of the characteristics of angiosarcoma, and also stresses the need to include angiosarcoma in the differential diagnosis of rare lesions located in the CP angle.
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PMID:Primary cerebellopontine angle angiosarcoma. 1831 34

Retiform hemangioendothelioma (RH) is an extremely rare low-grade angiosarcoma mainly involving the skin and subcutaneous tissue. Clinically patients often present with an asymptomatic slow-growing solitary nodular or plaque-like lesion. RH is characterized by frequent local recurrences but a very low metastatic rate. Here we reported a case of RH in a 61-year-old Chinese woman who presented with a rapid growing cutaneous plaque-like lesion on her right scalp, followed by another lesion behind the right ear. The lesions were associated with paroxysmal sharp needle-stabbing like headache. She underwent wide excision and skin engraftment. Three months post surgery, she experienced tumor recurrence, and died 9 months after the initial diagnosis.
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PMID:A case of retiform-hemangioendothelioma with unusual presentation and aggressive clinical features. 2060 34


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