title: Angiosarcoma arising in a patient with a 10-year-old hemangioma.
abstract: The transformation of a benign hemangioma into a malignant angiosarcoma has been rarely reported, with only 11 cases reported in the literature. There have been no reports of malignant transformation of hemangioma into angiosarcoma in association with epithelioid hemangioendothelioma, to our knowledge. The existence of precursor malignancies in the tumorigenesis of sarcomas is still not clearly defined. We describe the case of a 40-year-old woman with a preceding history of a suspected hemangioma for ten years, who upon resection was found on histology to have evidence of a hemangioma with an associated area of epithelioid hemangioendothelioma as well as areas of overt high grade epithelioid angiosarcoma. These findings raise the possibility of the evolution of hemangioma to epithelioid hemangioendothelioma, and the latter to overt angiosarcoma. The patient was managed as having a high grade sarcoma with wide resection and radiation. She declined systemic adjuvant chemotherapy after a thorough discussion about the risks and benefits of chemotherapy, and she currently remains disease free one year after the surgery.
authors.affiliation: University of Maryland Greenebaum Cancer Center, 22 South Greene Street, Suite 9D10, Baltimore, MD 21201, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Nathenson
authors.affiliation: Department of Pathology, Sinai Hospital, 2401 W. Belvedere Avenue, Baltimore, MD 21215, USA.
authors.forename: Diana
authors.initials: D
authors.lastname: Molavi
authors.affiliation: Sarcoma Services, Cancer Institute Sinai Hospital, 2401 W. Belvedere Avenue, Baltimore, MD 21215, USA ; Department of Orthopaedics, University of Maryland Medical Center, 22 South Greene Street, Baltimore, MD 21201, USA ; Harry and Jeanette Weinberg Cancer Institute, MedStar Franklin Square Medical Center, Baltimore, MD 21237, USA.
authors.forename: Albert
authors.initials: A
authors.lastname: Aboulafia