case_images: PMC10715254_01
case_images: Computed tomography (CT) and magnetic resonance (MR) images of multicentric angiosarcomas of bone. Sagittal and coronal CT image revealed bone destruction of the parietal bone (A), accompanied by soft tissue lesions (long arrows), with the largest measuring approximately 3.6 x 2.7 x 2.0 cm, protruding into the epidural space (B). MRI examination demonstrated lesions with slightly elevated signal intensity on T2FLAIR (C, long arrows), showing moderate enhancement on Fat-sat Gd-T1WI (D). Multiple foci were observed within the T12, L1-5, and S1-2 vertebrae, as well as in the bilateral iliac bones. These exhibited irregular signal patterns on fat-suppressed T2WI (E, long arrows) and mild enhancement on Fat-sat Gd-T1WI (F).
case_images: fmed-10-1330341-g001.jpg
case_images: PMC10715254_01_fmed-10-1330341-g001.jpg
case_images: fig1
case_images: Cranial CT scan revealed bone destruction of the parietal bone, accompanied by soft tissue lesions, with the largest measuring approximately 3.6 x 2.7 x 2.0 cm, protruding into the epidural space (Figures 1A,B). MRI examination demonstrated lesions with slightly elevated signal intensity on T2FLAIR (Figure 1C), showing moderate enhancement (Figure 1D). T12, L1-5, and S1-2 vertebrae, as well as in the bilateral iliac bones. These exhibited irregular signal patterns on fat-suppressed T2WI and mild enhancement (Figures 1E,F).
case_images: 18F-FDG PET/CT images of multicentric angiosarcomas of bone. The anteroposterior 3-dimensional maximum intensity projection image (MIP) revealed multifocal FDG-avid lesions in the sternum, bilateral clavicles, bilateral scapulae, multiple ribs, and pelvic bones (A). Sagittal images of the spine revealed the presence of multiple bone-destroying lesions (long arrows), with the highest FDG uptake detected in the T6 vertebra (B, SUVmax = 7.6). Heterogeneous FDG uptake was observed in multiple bone lesions (arrowheads), including intracranial (C,D, SUVmax = 11.3), right transverse process of the T10 vertebra (E,F, SUVmax = 5.8), ilium (G,H, SUVmax = 3.3), and pubis (I,J, SUVmax = 4.7).
case_images: fmed-10-1330341-g002.jpg
case_images: PMC10715254_01_fmed-10-1330341-g002.jpg
case_images: fig2
case_images: For staging, 18F-FDG PET/CT was performed (Figures 2A-J).
case_images: Histopathological and immunohistochemical images. Hematoxylin-eosin (HE) staining (magnification x 200) revealed irregular vascular channels and hyperplasia of atypical cells arranged in a diffuse sheet-like growth pattern (A). Immunohistochemistry showed that the positive expression of CD31 (B), CD34 (C) and FLI-1 (D) of the tumor cells (magnification x 200).
case_images: fmed-10-1330341-g003.jpg
case_images: PMC10715254_01_fmed-10-1330341-g003.jpg
case_images: fig3
case_images: Hematoxylin and eosin staining revealed irregular vascular channels and hyperplasia of atypical cells arranged in a diffuse sheet-like growth pattern (Figure 3A). Immunohistochemical staining showed positive expression of CD31 (Figure 3B), CD34 (Figure 3C), ERG, FLI-1 (Figure 3D), and SMA.