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Renal Angiosarcoma : Clinical Features

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The clinical features of renal angiosarcomas overlap with other renal tumors and include flank pain, hematuria, ureteric obstruction, fever, weight loss, and malaise. Some cases are asymptomatic and discovered incidentally. Rare tumors rupture resulting in hemoperitoneum.

Almost 50% of patients present with metastases, usually to multiple sites. The most common metastatic sites are lung and liver followed by peritoneum, spleen, bone, and abdominal lymph nodes.

Radiology: On imaging studies, the radiologic features are virtually indistinguishable from renal cell carcinoma. CT with contrast shows a heterogenous mass with peripheral enchancement. Preoperative diagnosis is rarely made. CT-guided fine needle aspiration biopsy sometimes generates sufficient material for diagnosis.

This image is a higher magnification from the previous slide showing plump endothelial cells with hyperchromatic nuclei lining vascular spaces.

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