Angiosarcoma of bone
Introduction
Introduction to osteovascular sarcoma Osteosarcoma is a highly malignant bone tumor that originates from vascular endothelial cells in the bone and can be transferred to the lungs early. Also known as vascular sarcoma, malignant bone hemangioma, malignant hemangioendothelioma. Mainly manifested as local pain and swelling, sometimes can touch the blood vessels and hear vascular noise. The tenderness is obvious and can be associated with limb dyskinesia. basic knowledge The proportion of sickness: 0.01% Susceptible people: no specific population Mode of infection: non-infectious Complications: fracture
Cause
Cause of osteovascular sarcoma
Cause:
The cause is unknown.
Pathogenesis
1. Visual observation: The tumor consists of hemorrhagic sponge-like tissue, which is purple-red or dark brown. The texture is brittle and soft, sometimes granulated, accompanied by new and messy small blood vessels. The boundary with the surrounding tissue is unclear. membrane.
2. Microscopic findings: The tumor consists of numerous vascular cavities that are consistent with each other. The lumen wall is lined with a proliferating, heterogeneous monolayer or multilamellar endothelial cell. When the differentiation is good, there is a circular or fissured vascular cavity in the tumor tissue. There are circular or elliptical atypical endothelial cells around, which are larger than normal cells, mildly atypia, round or oval, with increased chromatin, obvious nucleoli, abundant cytoplasm, lightly stained or finely granulated. The cells with poor differentiation are fusiform, with obvious variability, many mitotic divisions, no tendency to form vascular lumens or only small cavities, but the contours of the vessel wall can be displayed on the silver stained sections, and see the argyrophilic fiber pack. A small group is formed around the tumor cells, indicating that the tumor cells are argyrophilic hyperplasia of the blood vessel wall.
Prevention
Osteosarcoma prevention
(1) It is advisable to eat more foods with anti-bone tumor effects: goat blood, scorpion, crab, sheep brain, sea cucumber, oyster, cockroach, turtle, sand worm, deer blood, big leafy vegetables, oatmeal, small leeks, rapeseed, Sand dates, citron, chestnut, wild grapes.
(2) It is advisable to eat foods that have the effect of relieving pain and swelling: asparagus, medlar, sage, hawthorn, clam meat, heron, crab, clam, sea turtle, sea snake.
(3) It is advisable to eat foods that prevent side effects of radiotherapy and chemotherapy: bee milk, walnut, kiwi, white fungus, sweet aunt, kohlrabi, pollen.
Complication
Osteovascular sarcoma complications Complications
Pathological fractures can occur, which can cause paraplegia or major paralysis of the nerve when the tumor invades the spinal cord.
Symptom
Symptoms of osteovascular sarcoma Common symptoms Limb vascular murmur dull pain paraplegia
The initial symptoms are mild, the progress is slow, and sometimes the tumor is large, but the symptoms are still not obvious. The time from symptom onset to visit is usually 2-8 months, and the individual can reach 3 years. Once the symptoms appear, the development is faster. It is characterized by local pain and swelling. Sometimes it can touch the pulsation of blood vessels and hear murmurs. The tenderness is obvious and the movement of the limbs is dysfunctional. With the development of the tumor, the bone destruction is progressively aggravated. The cortical bone is worn through, and a soft tissue mass appears. Unclear boundaries, tenderness, increased skin temperature, venous engorgement, pathological fractures, loss of limb function, vertebrae, vertebral collapse, pathological compression fractures, bone and tumor compression or invasion of spinal nerves, causing paraplegia Or nerve paralysis, difficulty in urinary and bladder, the development of tumors without lymphatic metastasis, and more through local spread, some cases of cis-blood long-distance transfer to the lungs.
The disease is slow onset, mild symptoms, mainly dull pain and swelling, gradually increased, can touch the blood vessels beat or hear vascular noise, tenderness is obvious. Imaging findings are scattered or irregular patchy or foamy osteolytic destruction with radial bone and soft tissue masses. Angiography has a large number of messy neovascular plexuses or pools.
Examine
Examination of osteovascular sarcoma
Imaging findings: a single lesion invades a part of the bone, which is more common in the long bones. Multiple lesions can invade most of the bones. The spine can invade a vertebral body or several vertebral bodies. Irregular and irregular patchy, foamy or fused into large slices of osteolytic destruction, blurred edges, severe pathological fractures often occur, vertebral body can be compressed and flattened, vertebral arch disappears, tumor wears through the bone When the cortex expands into the soft tissue, residual triangular periosteal reaction may occur. The swelling and mass of the soft tissue are very obvious. There is no calcification, and there are often uneven thickness around the tumor bone. The radial bone needles of different lengths are perpendicular to the backbone. Layered periosteal reaction.
Angiography can cause a large number of irregular and distorted tumor blood vessels, arteriovenous fistula, early vein development, signs of malignant tumors such as newly-generated disordered vascular bundles and tumor lakes.
Diagnosis
Diagnosis and diagnosis of bone angiosarcoma
The onset of the disease is slow, the symptoms are mild, mainly due to dull pain and swelling, gradually increasing, can touch the pulsation of the blood vessels or hear vascular murmurs, tenderness is obvious, and the imaging findings are irregularly distributed patchy or foamy Osteolytic destruction, radial bone and soft tissue mass, angiography, a large number of disordered neovascular plexus or pool, clinical consideration should be considered for the diagnosis of osteosarcoma, if the tumor tissue is seen by numerous vascular cavities, lumen wall It is composed of hyperplastic heterogeneous endothelial cells. The silver staining shows the contour of the blood vessel wall, and the argyrophilic fibers surround the tumor cells to form a small group. The histologically confirmed osteosarcoma.
This tumor should be distinguished from fibrosarcoma, giant cell tumor of bone, telangiectasia osteosarcoma, malignant lymphoma, Ewing's sarcoma and metastatic cancer.
