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Case Reports in Oncological Medicine
Volume 2014, Article ID 185323, 5 pages
Case Report

Angiosarcoma Arising in a Patient with a 10-Year-Old Hemangioma

1University of Maryland Greenebaum Cancer Center, 22 South Greene Street, Suite 9D10, Baltimore, MD 21201, USA
2Department of Pathology, Sinai Hospital, 2401 W. Belvedere Avenue, Baltimore, MD 21215, USA
3Sarcoma Services, Cancer Institute Sinai Hospital, 2401 W. Belvedere Avenue, Baltimore, MD 21215, USA
4Department of Orthopaedics, University of Maryland Medical Center, 22 South Greene Street, Baltimore, MD 21201, USA
5Harry and Jeanette Weinberg Cancer Institute, MedStar Franklin Square Medical Center, Baltimore, MD 21237, USA

Received 2 October 2014; Revised 17 December 2014; Accepted 17 December 2014; Published 31 December 2014

Academic Editor: Marcel W. Bekkenk

Copyright © 2014 Michael J. Nathenson et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The transformation of a benign hemangioma into a malignant angiosarcoma has been rarely reported, with only 11 cases reported in the literature. There have been no reports of malignant transformation of hemangioma into angiosarcoma in association with epithelioid hemangioendothelioma, to our knowledge. The existence of precursor malignancies in the tumorigenesis of sarcomas is still not clearly defined. We describe the case of a 40-year-old woman with a preceding history of a suspected hemangioma for ten years, who upon resection was found on histology to have evidence of a hemangioma with an associated area of epithelioid hemangioendothelioma as well as areas of overt high grade epithelioid angiosarcoma. These findings raise the possibility of the evolution of hemangioma to epithelioid hemangioendothelioma, and the latter to overt angiosarcoma. The patient was managed as having a high grade sarcoma with wide resection and radiation. She declined systemic adjuvant chemotherapy after a thorough discussion about the risks and benefits of chemotherapy, and she currently remains disease free one year after the surgery.