title: Multifocal epithelioid angiosarcoma of bone: a potential pitfall in the differential diagnosis with metastatic carcinoma.
abstract: A case of multifocal epithelioid angiosarcoma of the femur, tibia, fibula, and astragalus in a 54-year-old man is reported. The tumor was composed of nests and cords of malignant cells with epithelioid morphology, with foci of vascular differentiation, necrosis, and hemorrhage. By immunohistochemistry, the neoplastic cells showed positivity for endothelial cell markers (CD31, CD34, factor VIII-related antigen, and Ulex europaeus agglutinin I), epithelial markers (cytokeratins and epithelial membrane antigen), and vimentin. The authors' findings point out the need for a panel of antibodies for the careful search of histologic features of vascular differentiation to correctly diagnose vascular bone tumors with epithelioid features, especially in evaluating small core biopsy specimens in which a sheetlike rather than obviously vasoformative architecture may lead to an erroneous diagnosis of metastatic carcinoma.
authors.affiliation: Dipartimento di Biopatologia e Diagnostica per Immagini, Sezione di Anatomia Patologica, Università degli Studi di Roma Tor Vergata, Via Montepellier 1, 00133 Rome, Italy. santeusanio@med.uniroma2.it
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Santeusanio
authors.forename: Alessandro
authors.initials: A
authors.lastname: Bombonati
authors.forename: Umberto
authors.initials: U
authors.lastname: Tarantino
authors.forename: Paolo
authors.initials: P
authors.lastname: Craboledda
authors.forename: Bonaventura
authors.initials: B
authors.lastname: Marino
authors.forename: Ruth
authors.initials: R
authors.lastname: Birbe
authors.forename: Angela
authors.initials: A
authors.lastname: Ortenzi
authors.forename: Sergio
authors.initials: S
authors.lastname: Villaschi
mesh_terms: D015415:Biomarkers / Q000032:analysis; D003937:Diagnosis, Differential; D004730:Endothelium, Vascular / Q000473:pathology; D004847:Epithelial Cells / Q000473:pathology*; D006394:Hemangiosarcoma / Q000737:chemistry / Q000175:diagnosis / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000175:diagnosis / Q000473:pathology; D014746:Vimentin / Q000032:analysis
chemical_list: D015415:Biomarkers; D014746:Vimentin