Angiosarcoma developing in a non-functioning arteriovenous fistula post-renal transplant.
BACKGROUND
Angiosarcomas comprise less than 1% of all sarcomas, arising from endothelial cells of blood or lymph vessels. Chronic immunosuppression increases the risk of many malignancies and an association between the development of angiosarcoma with an immunosuppressed state is established. A few cases have been reported of angiosarcomas arising in the post-renal transplant patient. Specifically, there have been six cases of an angiosarcoma arising in arteriovenous (AV) fistulae in this patient population. We describe a further case and review the relevant literature with specific emphasis on a possible mechanism for the development of angiosarcoma in the post-transplant patient.


METHODS
We report the case of a 48-year-old male who developed an angiosarcoma in a ligated native AV fistula. The lesion arose on the background of immunosuppression following a successful ABO-incompatible renal transplant for chronic renal failure.


CONCLUSIONS
Angiosarcomas are extremely rare tumours but should be considered as a differential diagnosis for an evolving mass near the site of an AV fistula. Diagnosis relies on an index of suspicion and obtaining a definitive histological diagnosis. Both clinicians and patients should be aware that an evolving mass within or around an AV fistula should prompt urgent biopsy.
Qureshi
Yassar A
YA
The Royal Marsden Hospital, Soft Tissue Sarcoma Unit, London, UK. yassarqureshi@hotmail.co.uk
Strauss
Dirk C
DC
Thway
Khin
K
Fisher
Cyril
C
Thomas
J Meirion
JM
D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D006394:Hemangiosarcoma / Q000209:etiology* / Q000473:pathology; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D007676:Kidney Failure, Chronic / Q000601:surgery; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D019043:Vascular Neoplasms / Q000209:etiology* / Q000473:pathology