Bladder & urothelial tract
Other tumors
Angiosarcoma
Author: Turki Al-Hussain, M.D.
Last author update: 1 December 2014
Last staff update: 25 August 2021
Copyright: 2003-2024, PathologyOutlines.com, Inc.
PubMed Search: Bladder angiosarcoma
Table of Contents
Definition / general | Epidemiology | Etiology | Clinical features | Case reports | Treatment | Gross description | Microscopic (histologic) description | Positive stains | Differential diagnosisCite this page: Al-Hussain T. Angiosarcoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/bladderangiosarcoma.html. Accessed April 19th, 2024.
Definition / general
- Rare vascular tumor with anastomosing vascular channels
- Endothelial cells usually exhibit marked cytologic atypia
Epidemiology
- Mean age 64 years, 89% occur in males
Etiology
- Due to radiation therapy for pelvic malignancy in 1/3; also exposure to arsenic, thorium dioxide, polyvinyl chloride or chemotherapeutic agents
- It has been reported to arise in bladder with preexisting hemangioma
Clinical features
- Patients typically present with hematuria
- Traditionally considered to have a poor prognosis, but see (Arch Pathol Lab Med 2006;130:1543)
Case reports
- Survival 6 years after initial presentation (Urology 2007;69:575.e9)
Treatment
- Wide radical resection, possibly radiotherapy/chemotherapy
Gross description
- Hemorrhagic, raised mass (mean 7 cm) of trigone or dome
Microscopic (histologic) description
- Anastomosing vascular channels lined by plump hyperchromatic cells
- Also solid growth and epithelioid cytology
- Typically invades the muscularis propria (Am J Surg Pathol 2008;32:1213)
Positive stains
- CD31, CD34
- Cytokeratin can be focally positive, especially in epithelioid tumors
Differential diagnosis
- Hemangioma: typically 1 cm or less, 80% are cavernous, no atypia, no anastomosing or solid areas
- Kaposi’s sarcoma: associated with HIV and HHV8; extravasated red blood cells present; usually less atypia than angiosarcoma
- Sarcomatoid urothelial carcinoma: undifferentiated spindle cells; associated urothelial carcinoma; vascular markers are negative
