Vascular tumors of bone

Author: Nat Pernick, M.D. (see Authors page)

Revised: 27 October 2016, last major update June 2005

Copyright: (c) 2003-2016,, Inc.

PubMed search: angiosarcoma [title] bone

Related topics: Epithelioid angiosarcoma
Cite this page: Angiosarcoma. website. Accessed August 17th, 2018.
Definition / general
  • Also called hemangioendothelioma in bone, although angiosarcomas have more cytologic atypia
  • Rare; may be multicentric
  • 1 / 3 affect long tubular bones, but any bone may be affected
  • 1 / 3 are multifocal, usually in one geographic area, such as an entire leg
  • After diagnosis, search for multicentricity
  • Distant metastases common, often to lungs
  • Graded 1 - 3 based on atypia of endothelial cells
  • Grade 1 have excellent prognosis vs. poor prognosis for grade 3
Radiology description
  • Lytic areas of destruction, with minimal / no reactive new bone formation
Gross description
  • Red, hemorrhagic
Gross images
Images hosted on PathOut server:

Primary bone multifocal - contributed by Dr. Mark R. Wick

Microscopic (histologic) description
  • Obvious atypia of tumor cells, solid areas alternating with irregular, anastomosing vascular channels
  • Necrosis and hemorrhage, brisk mitotic activity
  • Variable differentiation often within same tumor; may be epithelioid or histiocytic
  • May have benign giant cells, eosinophils, occasionally reactive bone formation
Microscopic (histologic) images
Images hosted on PathOut server:

Grade 3

Primary bone - contributed by Dr. Mark R. Wick

Electron microscopy description
  • Endothelial cell features, may have pericytic features
Additional references