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Angiosarcoma of the humerus presenting with fluid–fluid levels on MRI: a unique imaging presentation

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Fluid–fluid levels are a known feature of a number of osseous lesions, but have never before been described in primary osseous angiosarcoma, which is itself a rare malignancy. We report a case of humeral angiosarcoma presenting with fluid–fluid levels. Recognizing this entity as a possible etiology for fluid–fluid levels could help radiologists to avoid potential confusion in the differential diagnosis on imaging.

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  1. Santeusanio G, Bombonati A, Tarantino U, Craboledda P, Marino B, Birbe R, et al. Multifocal epithelioid angiosarcoma of bone: a potential pitfall in the differential diagnosis with metastatic carcinoma. AIMM Off Publ Soc Appl Immunohistochem. 2003;11(4):359–63.

    Article  Google Scholar 

  2. Vermaat M, Vanel D, Kroon HM, Verbeke SL, Alberghini M, Bovee JV, et al. Vascular tumors of bone: imaging findings. Eur J Radiol. 2011;77(1):13–8.

    Article  PubMed  Google Scholar 

  3. Hasegawa T, Fujii Y, Seki K, Yang P, Hirose T, Matsuzaki K, et al. Epithelioid angiosarcoma of bone. Hum Pathol. 1997;28(8):985–9.

    Article  PubMed  CAS  Google Scholar 

  4. Verbeke SL, Bertoni F, Bacchini P, Sciot R, Fletcher CD, Kroon HM, et al. Distinct histological features characterize primary angiosarcoma of bone. Histopathology. 2011;58(2):254–64.

    Article  PubMed  Google Scholar 

  5. Mittal S, Goswami C, Kanoria N, Bhattacharya A. Post-irradiation angiosarcoma of bone. J Cancer Res Ther. 2007;3(2):96–9.

    Article  PubMed  Google Scholar 

  6. Verbeke SL, Bovee JV. Primary vascular tumors of bone: a spectrum of entities? Int J Clin Exp Pathol. 2011;4(6):541–51.

    PubMed  Google Scholar 

  7. Murphey MD, Fairbairn KJ, Parman LM, Baxter KG, Parsa MB, Smith WS. From the archives of the AFIP. Musculoskeletal angiomatous lesions: radiologic-pathologic correlation. Radiogr Rev Publ Radiol Soc N Am Inc. 1995;15(4):893–917.

    CAS  Google Scholar 

  8. Wenger DE, Wold LE. Malignant vascular lesions of bone: radiologic and pathologic features. Skeletal Radiol. 2000;29(11):619–31.

    Article  PubMed  CAS  Google Scholar 

  9. Errani C, Vanel D, Gambarotti M, Alberghini M, Picci P, Faldini C. Vascular bone tumors: a proposal of a classification based on clinicopathological, radiographic and genetic features. Skeletal Radiol. 2012;41(12):1495–507.

    Article  PubMed  Google Scholar 

  10. Deshpande V, Rosenberg AE, O’Connell JX, Nielsen GP. Epithelioid angiosarcoma of the bone: a series of 10 cases. Am J Surg Pathol. 2003;27(6):709–16.

    Article  PubMed  Google Scholar 

  11. Volpe R, Mazabraud A. Hemangioendothelioma (angiosarcoma) of bone: a distinct pathologic entity with an unpredictable course? Cancer. 1982;49(4):727–36.

    Article  PubMed  CAS  Google Scholar 

  12. Van Dyck P, Vanhoenacker FM, Vogel J, Venstermans C, Kroon HM, Gielen J, et al. Prevalence, extension and characteristics of fluid-fluid levels in bone and soft tissue tumors. Eur Radiol. 2006;16(12):2644–51.

    Article  PubMed  Google Scholar 

  13. O’Donnell P, Saifuddin A. The prevalence and diagnostic significance of fluid-fluid levels in focal lesions of bone. Skeletal Radiol. 2004;33(6):330–6.

    Article  PubMed  Google Scholar 

  14. Vilgrain V, Boulos L, Vullierme MP, Denys A, Terris B, Menu Y. Imaging of atypical hemangiomas of the liver with pathologic correlation. Radiogr Rev Publ Radiol Soc N Am Inc. 2000;20(2):379–97.

    CAS  Google Scholar 

  15. Ghai S, Dill-Macky M, Wilson S, Haider M. Fluid-fluid levels in cavernous hemangiomas of the liver: baffled? AJR Am J Roentgenol. 2005;184(3 Suppl):S82–5.

    Article  PubMed  Google Scholar 

  16. Weiss SW, Goldblum JR. Malignant vascular tumors. Enzinger and Weiss’s soft tissue tumors. Philadelphia: Mosby Elsevier; 2008. p. 703–12.

    Google Scholar 

  17. Lomasney LM, Martinez S, Demos TC, Harrelson JM. Multifocal vascular lesions of bone: imaging characteristics. Skeletal Radiol. 1996;25(3):255–61.

    Article  PubMed  CAS  Google Scholar 

  18. Roessner A, Boehling T. Angiosarcoma. In: Fletcher CDM, Unni KK, Mertens F, editors. Pathology and genetics of tumours of soft tissue and bone. Lyon: IARC Press; 2002. p. 322–3.

    Google Scholar 

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Correspondence to Brent Griffith.

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Griffith, B., Yadam, S., Mayer, T. et al. Angiosarcoma of the humerus presenting with fluid–fluid levels on MRI: a unique imaging presentation. Skeletal Radiol 42, 1611–1616 (2013).

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