Putro Yuni Artha Prabowo, Magetsari Rahadyan, Anzhari Sharfan, Prasetyo Thomas Edison, Huwaidi A Faiz, Akbar Kautsar
Oncology Divison of Orthopedics and Traumatology Department, RSUP Dr. Sardjito Hospital, Jl. Kesehatan Sendowo No.1, Sleman, 55281, D.I.Yogyakarta, Indonesia; Orthopedics and Traumatology Department, RSUP Dr. Sardjito Hospital, Jl. Kesehatan Sendowo No.1, Sleman, 55281, D.I.Yogyakarta, Indonesia.
Oncology Divison of Orthopedics and Traumatology Department, RSUP Dr. Sardjito Hospital, Jl. Kesehatan Sendowo No.1, Sleman, 55281, D.I.Yogyakarta, Indonesia; Orthopedics and Traumatology Department, RSUP Dr. Sardjito Hospital, Jl. Kesehatan Sendowo No.1, Sleman, 55281, D.I.Yogyakarta, Indonesia.
Int J Surg Case Rep. 2024 Sep;122:110124. doi: 10.1016/j.ijscr.2024.110124. Epub 2024 Aug 13.
Angiosarcoma is a high-grade endothelial sarcoma rarely found in the bones. Challenges lie in its rareness, high mortality, metastasis, and recurrence. The role of radiotherapy and chemotherapy in managing angiosarcoma remains debatable, while surgery stands out as the optimal treatment for local control. We present a patient with angiosarcoma of the bone, managed through a combination of surgery and radiotherapy.
A 66-year-old male presented with pain on the right distal femur and was unable to weight bearing after lifting a box. The X-ray showed a fracture and lytic lesion. The patient has lost 5 kg of body weight in the last 3 months. The Clinicopathological Conference (CPC) suspects a malignancy process, prompting us for wide resection, biopsy, and ORIF with cement augmentation. Histopathology and immunohistochemistry results confirmed the diagnosis of angiosarcoma. We decide to manage patients with radiotherapy without chemotherapy and regular monthly monitoring. The patient exhibited clinical improvement.
Angiosarcoma of the bone tends to have a bad prognosis. Diagnosis might be challenging as it is a rare condition and could be easily confused with another disease. The routine CPC we held was beneficial for the diagnosis and treatment of the patient. The combination of surgery and radiotherapy is yielding positive outcomes.
Angiosarcoma should be considered in patients with osteolytic lesions in the bone. Surgery and radiotherapy are important to local control in patients with angiosarcoma.
血管肉瘤是一种高级别内皮肉瘤，在骨骼中很少见。其罕见性、高死亡率、转移和复发带来了挑战。放疗和化疗在血管肉瘤治疗中的作用仍存在争议，而手术是局部控制的最佳治疗方法。我们报告一例骨血管肉瘤患者，通过手术和放疗联合治疗。
一名66岁男性因右股骨远端疼痛就诊，搬箱子后无法负重。X线显示骨折和溶骨性病变。患者在过去3个月体重减轻了5千克。临床病理讨论会（CPC）怀疑为恶性病变，促使我们进行广泛切除、活检以及带骨水泥强化的切开复位内固定术。组织病理学和免疫组化结果确诊为血管肉瘤。我们决定对患者进行放疗，不进行化疗，并每月定期监测。患者病情出现临床改善。
骨血管肉瘤预后往往较差。由于其罕见且易与其他疾病混淆，诊断可能具有挑战性。我们进行的常规CPC对患者的诊断和治疗有益。手术和放疗联合取得了积极效果。
对于有骨溶骨性病变的患者应考虑血管肉瘤。手术和放疗对血管肉瘤患者的局部控制很重要。
