Vascular Tissue- Soft tissue tumours Flashcards Preview

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Flashcards in Vascular Tissue- Soft tissue tumours Deck (12):
1

What is an Haemangioma?

  • Benign vascular neoplasm in soft tissue
  • may be cutaneous, subcutaneous, intramuscular
  • capillary ( superificial )or cavernous ( deep)
  • M=F
  • <1% All benign vascular tumours
  • common pts <30 yrs
  • location
    • intramuscular is deep in lower extremities
    • often isolated lesions except diffuse haemangioma (involves a single limb in childhood)
    • commonly in the hand

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2

What is the pathophysiology of  haemangiomas?

  • Caused by error in the new formation of a segment of the vascular system
  • 20% assoc with trauma

3

What is the prognosis of haemangiomas?

  • Infantile haemangiomas involute by age 7
  • no incidence of malignant transformation

4

How do haemangiomas present?

  • Symptoms
    • Pain variable
    • if large- 
      • aching
      • heaviness
      • swelling

O/E

  • mass of variable size depending on activity level- see pic

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5

What is seen on imaging of haemangiomas?

  • Xrays
    • small phleboliths inside the lesion- see pic
  • MRI w gadolinium
    • increased signal on T1 & T2

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6

What is the tx of haemangiomas?

non operative

  • Observation, NSAIDS, VAscular stockings & activity modification
    • first line tx
    • childhood lesions
  • Sclerotherapy or emobilisation
    • by inteventional radiologist
    • large , painful lesions fail nsaids/stocking

Operative

  • Marginal excision
    • small lesions in hand
  • Wide surgical resection
    • for those lesions resistant to non op mx
    • high incidence of local recurrence
  •  

7

What is the complication of haemangiomas?

  • Kasabach-Meritt Syndrome
    • rare complx caused by entrapped platelets -> possibly fatal coagulopathy

8

What is an angiosarcoma?

  • Rare Malignant & very aggressive tumour that derived from endothelium of blood vessels 
  • M>F
  • elderly pts
  • locations
    • osseous invovlement <10% ( 60% long bones)
  • Risk factors
    • trauma
    • chronic vascular stasis

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9

What is the prognosis of Angiosarcoma?

  • Poor
  • High failure rate & amputation required
  • Propensity for lymphatic spread
  • Mets to lung common

10

What are the symptoms of Angiosarcoma?

  • Pain
  • symptoms often insidious
  • hallmark with overlying skin changes

11

What is seen on imaging of Angiosarcoma?

  • xray - invasion into bone
  • MRI-to evaulate soft tissue mass
  • cd31  in histology is sensitive marker for Angiosarcoma

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12

What is the tx of Angiosarcoma?

Operation

  • Wide surgical resection
    • tx of choice
    • Insensitive to chemo/radiation
  • Amputation
    • for agressive tumour
    • to gain local control