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The objectives of this study were to evaluate the risk and predictive factors of splenic malignancy and hemangiosarcoma in dogs undergoing splenectomy at a surgical specialty clinic. Medical records, hematologic results, surgical reports, and histopathologic results from 182 dogs that underwent splenectomy for the treatment of splenic masses or nodules were reviewed retrospectively. The majority of dogs (57.7%) had benign splenic diagnoses with no malignancy. Hemangiosarcoma was diagnosed in 32.4% of the dogs. A final multivariable model indicated that thrombocytopenia, anemia, and a smaller diameter of the largest splenic nodule were risk factors for hemangiosarcoma (P<0.001), and hemoperitoneum (P = 0.01) was an additional risk factor when nodule diameter was not evaluated. There were 91 dogs that had hemoperitoneum, and 60.4% of those dogs had malignant splenic lesions. Of the 33 dogs that underwent a splenectomy for incidentally identified splenic lesions, 93.9% had benign splenic lesions. Breed size was not a significant predictor of splenic malignancy risk; however, all 6 of the German shepherds included in the study had a hemangiosarcoma diagnosis. Overall prevalence of splenic malignancy including HSA may be overestimated in some canine populations.

Background Secondary angiosarcoma of the breast is a rare but severe long-term complication of breast cancer treated with breast-conserving surgery and radiotherapy. We characterized a population-based cohort of patients with secondary angiosarcomas from two tertiary hospitals to investigate this complication with respect to surgical treatment and outcome. Methods We identified 35 patients with a history of radiation for breast cancer that developed angiosarcoma in the irradiated field from 1990 to 2009. Of these, 31 underwent surgery and were included for analysis. Results Angiosarcoma developed after median 7 years (range 3–25 years). R0 resection was obtained in 23 of 31 patients after primary treatment. Local recurrence developed in 19 patients after median 6 months (range 1–89 months). Regional and distant metastases occurred in 13 patients after median 17 months (range 2–50 months); nine which also had local recurrence. Patients whose local recurrence could be operated on had a better survival after treatment than those who were not considered for surgical treatment, median 34 months (range 6–84 months) compared with 6 months (range 5–24 months). The median disease-free survival and disease-specific survival was 16 and 37 months, respectively. Conclusions Despite R0 resection, two-thirds of the patients developed a local recurrence. Survival among those with local recurrence was better if the patient could be treated with surgery. Overall, the prognosis was dismal and median DSS was just over 3 years.

Abstract Ovarian angiosarcomas are rare tumors, with an incidence of one in 1,000,000 malignant ovarian tumors, which may present in a background of carcinosarcoma or teratoma. However, primary pure ovarian angiosarcoma is even rarer with a few cases published in the literature. Here, we present a case of a perimenopausal woman who presented with a 16 cm adnexal mass. She underwent bilateral salpingo-oophorectomy with omentectomy, which on histopathological examination revealed an ovarian angiosarcoma with tumor deposits in the pelvic peritoneum. No other component was demonstrable within the tumor, in light of which it was reported as a primary pure ovarian angiosarcoma. She received adjuvant paclitaxel- and carboplatin-based chemotherapy after discussion in a multispecialty tumor board. This case highlights the gross and microscopic findings of primary ovarian angiosarcomas and their distinction from their differential diagnosis.

Epithelioid angiosarcoma (EA) is a malignant tumor of endothelium origin that most commonly arises in the deep soft tissues of extremities but may occasionally be primary in skin, adrenal gland, and bone. A 72-year-old male presented with a painless enlargement of his thyroid for more than 10 days before hospitalization. A walnut-sized mass in the right thyroid was found simultaneously by palpation and Color Doppler Ultrasound. After a total thyroidectomy was performed, a mass with a size of 4.5 cm × 3.5 cm was found at the lower pole of the right thyroid gland. Histologically, the tumor was diffusely distributed in a sheet-like pattern, with tumor cells being epithelioid. There was extensive coagulative necrosis while no components of papillary carcinoma, follicular carcinoma and insular poorly differentiated carcinoma were noticed. CD31 and vimentin were positive for immunostaining. The diagnosis of primary epithelioid angiosarcoma of right thyroid was then given to the patient. Eleven months after the operation, the patient died from brain metastasis. It is suggested that primary epithelioid angiosarcoma of thyroid, as an extremely rare tumor, have no characteristic clinical manifestations, laboratory and imaging examinations, and the diagnosis mainly depend on its unique clinical pathological features. Although extensive surgical resection is the preferred treatment, the prognosis is still very poor.

BackgroundRadiation-associated angiosarcoma of the breast (RAASB) is an aggressive malignancy that is increasing in incidence. Only a few previous population-based studies have reported the results of RAASB treatment.MethodsA search for RAASB patients was carried out in the Finnish Cancer Registry, and treatment data were collected to identify prognostic factors for survival.ResultsOverall, 50 RAASB patients were identified. The median follow-up time was 5.4 years (range 0.4–15.6), and the 5-year overall survival rate was 69%. Forty-seven (94%) patients were operated on with curative intent. Among these patients, the 5-year local recurrence-free survival, distant recurrence-free survival, and overall survival rates were 62%, 75%, and 74%, respectively. A larger planned surgical margin was associated with improved survival.ConclusionsWe found that the majority of RAASB patients were eligible for radical surgical management in this population-based analysis. With radical surgery, the prognosis is relatively good.

Background This study aims to describe a rare case of primary ureteral hemangiosarcoma, in which surgical intervention preserved the kidney and ureter after tumor removal. Case presentation A 13-year-old, neutered male dog, weighing 14 kg, mixed-breed, presented with apathy, anorexia, acute-onset vomiting, and abdominal discomfort during the physical examination. Ultrasonography and pyelography revealed a right-sided dilation of the renal pelvis and ureter due to complete obstruction in the middle third of the ureter. A mass obstructing the lumen of the right ureter was completely resected, and ureteral suturing was performed, preserving the integrity of the involved structures. Histopathology confirmed primary ureteral hemangiosarcoma. Due to the local and non-invasive nature of the mass, chemotherapy was not initiated. The patient’s survival was approximately two years, and normal renal function was preserved throughout this period. Conclusions Considering this type of tumor in the differential diagnosis of upper urinary tract obstructive disorders. Furthermore, the preservation of the ureter and kidney is a suitable therapeutic option after surgical resection of non-invasive tumors.

BackgroundLocalized breast angiosarcoma (LBA) is a rare condition with no prospective clinical trials guiding the management of afflicted patients. Management of LBA and the resulting outcomes on a nationwide scale has not been previously examined.MethodsThe National Cancer Data Base (NCDB) from 2004 to 2014 identified resected LBA patients. Treatment patterns were compared between three time periods (2004–2007, 2008–2011, and 2012–2014). Demographic and tumor characteristics, as well as treatments received—extent of surgery and adjuvant therapies—were analyzed for association with overall survival after adjustment for covariates.Results826 resected localized breast angiosarcoma patients were identified. Mastectomy was the most common surgical approach (86%); over 60% of patients did not receive adjuvant therapies after surgery. On multivariate analysis, tumor grade, tumor size, and surgical margins were associated with worse survival. Extent of surgery (mastectomy versus lumpectomy) and radiation therapy use were not associated with improved survival. Adjuvant chemotherapy was associated with improved survival in patients with primary tumors 5 cm and greater.ConclusionsThe extent of surgery is not associated with improved survival in women with LBA, and patients may consider breast-conservation surgery. Adjuvant therapies are not associated with improved survival, with the exception of possible role of adjuvant chemotherapy in large primary tumors (5 cm or greater). Further clinical studies are needed to determine the impact of these treatments on local control, progression-free survival, and patients’ quality of life. Until then, the findings of our analysis will form basis for the multi-disciplinary discussion of management of women with LBA.

Primary breast angiosarcoma is an uncommon, aggressive vascular tumour that poses diagnostic difficulties due to overlapping clinical, radiological and histological features. We describe a patient who presented with a painless breast lump where initial cytology suggested ductal carcinoma, and core needle biopsy showed fibroadenoma. Immunohistochemistry (IHC) confirmed angiosarcoma. She underwent a mastectomy with axillary dissection. Final histopathology showed a poorly differentiated angiosarcoma with negative margins and no nodal involvement. Adjuvant radiotherapy (intensity-modulated radiation therapy with active breathing control, 66 Gy in 33 fractions) was delivered, and adjuvant chemotherapy was not administered after tumour board discussion. At 2 years follow-up, she remains disease free. This case underlines the potential for diagnostic misclassification, the importance of IHC for accurate diagnosis and the value of multidisciplinary management in achieving favourable outcomes.