Angiosarcoma of urinary bladder - case report and the problematic of its bioptical diagnosis

Introduction: Angio sarcomas are rare malignant neoplasms of endothelial origin, which represent approximately 1 - 2 % of all soft tissue sarcomas and less than 1 % of all vascular tumors. They occur most frequently in the skin and subcutaneous tissue on the head and neck. Visceral organs are affected only very sporadically. Case: The authors of the article present a case report of 42-year old man, who was diagnosed to have an angiosarcoma of the urinary bladder in advanced stage with involvement of the surrounding tissue structures. Histologically, the tumor predominantly consisted of solid population of malignant pleomorphic epithelioid cells, that formed multiple anastomosing channels. For a definitive diagnosis, it was necessary to use a wide range of immunohistochemical examinations, of which the final results favored a diagnosis of epithelioid angiosarcoma. The clinical course of disease was fatal and a patient died within 2 months after operation. Conclusion: Epithelioid angiosarcoma is a rare type of malignancy, that occurs in urinary bladder only exceptionally. From the view of the pathologist it is important that the exact diagnosis is difficult to clarify, because this tumor histomorphologically and immunohistochemically mimics a wide range of malignant neoplasia of various histogenesis, and therefore, it requires a complex differential-diagnostic approach. (author)