Angiosarcoma : Risk Factors

The risk factors for angiosarcoma include:

• Chronic lymphedema of any origin - especially arms of female patients who had modified radical mastectomy with axillary lymph node dissection for breast cancer (Stewart-Treves Syndrome)
• Radiation - high doses, usually 50 Gy or more; for gynecologic and breast cancers, Hodgkin lymphoma
• Foreign bodies - AV fistula in renal transplant patients, shrapnel, synthetic vascular grafts, gouty tophi, arthroplasty, surgical sponges, and bone wax etc.
• Chemical carcinogens - Thorotrast for cerebral angiography (risk factor for hepatic angiosarcoma); exposure to vinyl chloride in rubber industry; exposure to arsenic containing insecticides in vineyard workers; and androgenic anabolic steroids
• Benign and malignant tumors - port wine stains, hemangiomas, lymphangiomas, nerve sheath tumors, leiomyomas
• Other diseases/conditions - Neurofibromatosis, bilateral retinoblastoma, xeroderma pigmentosum, Klippel-Trenaunay syndrome, chronic immunosuppression (HIV, renal transplantation), and stasis ulcers

This clinical photograph shows cutaneous angiosarcoma involving the thigh of an elderly male. The tumor is multifocal and consists of several large ulcerated, crusting and hemorrhagic lesions over a wide area (almost 30 cm). Many of the lesions are infected and covered with yellowish exudate. The periphery of the lesion consists of numerous red-purple papules and nodules.