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Interesting Image
40 (
3
); 168-169
doi:
10.4103/ijnm.ijnm_104_22

Rare Metastases to Liver and Spleen form a Seldom Case of Facial Angiosarcoma Demonstrated on Staging FDG PET-CT

Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India

Address for correspondence: Dr. Rakesh Kumar, Department of Nuclear Medicine, Division of Diagnostic Nuclear Medicine, All India Institute of Medical Sciences, New Delhi - 110 029, India. E-mail: rkphulia@yahoo.com

Licence
This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
Disclaimer:
This article was originally published by Wolters Kluwer - Medknow and was migrated to Scientific Scholar after the change of Publisher.

Abstract

Angiosarcoma is a rare type of soft-tissue sarcoma, constituting only 1% out of all soft-tissue sarcomas pathologically originating from lymphatic or vascular endothelial cells. Angiosarcomas are reported to be very aggressive with a high incidence of metastases to different sites; therefore, it is very important to determine disease extension and detect local recurrence and/or distant metastases for appropriate management. We report a case of a 55-year-old Indian male who presented with soft-tissue thickening of the left cheek for which biopsy revealed angiosarcoma and was referred for fludeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) to assess the extent of disease highlighting the potential role of FDG PET/CT in rare malignancies like angiosarcomas.

Keywords

Facial angiosarcoma
fludeoxyglucose positron emission tomography/computed tomography
liver and spleen metastasis
rare metastases
A 55-year-old male, who is a known case of histopathologically proven angiosarcoma, was referred for an 18F-fludeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) scan to assess the extent of disease [Figure 1]. (a) The maximum intensity projection of the patient showed intense FDG uptake involving right cervical lymph nodes and hepatosplenomegaly with metastasis to the liver and spleen. (b-e) Transverse images of the PET/CT fusion and the attenuation CT images demonstrated cutaneous tissue thickening overlying the left maxilla with increased FDG uptake, (f,g) shows metastases with increased FDG uptake to the liver and spleen. Angiosarcomas are known to be a rare type of sarcomas, accounting for only 1.6% of all soft-tissue sarcomas.[1] The most common anatomical sites of location are the head, neck, and breast, followed by other extremities.[2] The incidence among males is more common than among females, showing a 2:1 distribution.[3] Although there are few case reports of primary splenic angiosarcomas,[4] primary liver angiosarcomas,[5] and primary splenic angiosarcomas metastasizing to the liver,[6] to the best of our knowledge, there is no reported case of cutaneous angiosarcoma with metastasis to the cervical lymph nodes, liver, and spleen
Figure 1 A 55-year-old male, who is a known case of histopathologically proven angiosarcoma, was referred for an 18F-fludeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) scan to assess the extent of disease [Figure 1]. (a) The maximum intensity projection of the patient showed intense FDG uptake involving right cervical lymph nodes and hepatosplenomegaly with metastasis to the liver and spleen. (b-e) Transverse images of the PET/CT fusion and the attenuation CT images demonstrated cutaneous tissue thickening overlying the left maxilla with increased FDG uptake, (f,g) shows metastases with increased FDG uptake to the liver and spleen. Angiosarcomas are known to be a rare type of sarcomas, accounting for only 1.6% of all soft-tissue sarcomas.[1] The most common anatomical sites of location are the head, neck, and breast, followed by other extremities.[2] The incidence among males is more common than among females, showing a 2:1 distribution.[3] Although there are few case reports of primary splenic angiosarcomas,[4] primary liver angiosarcomas,[5] and primary splenic angiosarcomas metastasizing to the liver,[6] to the best of our knowledge, there is no reported case of cutaneous angiosarcoma with metastasis to the cervical lymph nodes, liver, and spleen

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given his consent for his images and other clinical information to be reported in the journal. The patient understands that his name and initials will not be published, and due efforts will be made to conceal his identity, but anonymity cannot be guaranteed.

Conflicts of interest

There are no conflicts of interest.

Nil.

References

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