Primary Angiosarcoma Of Scapula:A Rare Case Report And Review Of Literature

Objective:Primary angiosarcoma of the bone is an extremely rare malignant tumor with a incidence lower than 1% of the primary malignant tumor of the bone.The primary angiosarcoma of the scapula is even more infrequantly.Therefore,clinicians are not well aware of this disease.The disease are easily misdiagnosed as other soft tissue sarcomas or metastatic tumors.Accurate early diagnosis and evaluation are significant for the treatment and pose serious challenges for clinicians.Here,we report a case of primary angiosarcoma that occurred in the scapula in our hospital recently.Combined with the literature research,the article discusses the causes of the disease,clinical manifestations,imaging diagnosis,histopathology,immunohistochemistry,treatment and prognosis,to raise awareness of the disease.Materials and Methods:We report a case of primary angiosarcoma that occurred in the scapula diagnosed in the Department of Orthopaedics,the Second Affiliated Hospital of Nanchang University.Combined with the literature on primary vascular sarcoma of the pubmed database.The main causes,etiology,clinical manifestations and imaging features were analyzed.According to the characteristics of pathological histology and immunohistochemistry,the disease can be diagnosed early,which can reduce misdiagnosis and mistreatment rate,guide treatment and judge prognosis.Results:This 50-year-old female finally dignosed with primary angiosarcoma of scapular was admitted to our hospital for shoulder pain and a mass of the center in scapula.Physical examination revealed a hard masses that could not reach the boundary and were difficult to push.The peripheral blood count and other blood test indicators are almost normal.Imaging studies suggest localized space-occupying lesions with bone destruction.Postoperative immunohistochemical examinationshowed that the positive expression rate of endothelial cell markers such as FVIII-RA,CD31 and CD34 was higher in the diseased tissues.Conclusion:Primary angiosarcoma of the bone is a rare malignant tumor of bone vascular origin.It is common in the limb bone.The angiosarcoma originating in the scapula is more rare.The cause of the disease is not clear,but with multiple incentives.The performance is only local pain and swelling.The imaging examination has no obvious specificity for diagnosis,but it can be used as an important auxiliary examination for distinguishing from other bone soft tissue tumors.The final diagnosis depends on histopathology and immunohistochemistry.Standardized treatment options have not yet been established.Surgical resection and adjuvant radiotherapy are the first choice for this disease.Other treatments include chemotherapy and gene therapy.The clinical update anti-angiogenic therapy for angiosarcoma has made some good progress.