Abstract：
Epithelioid angiosarcoma is a rare high-grade vascular neoplasm with a poor prognosis. We present an anticoagulated 77-year-old man, with a history of popliteal/soleal vein thrombosis in the previous month, complaining of ipsilateral persistent lower limb pain and claudication. Absent popliteal/distal pulses prompted an arterial doppler ultrasound (DUS), revealing thrombosis of the distal superficial femoral artery and a popliteal mass. As the arterial wall\'s integrity could not be appropriately evaluated by DUS, adventitial cystic disease of the popliteal artery was suspected. Computed tomography angiography and magnetic resonance imaging findings were also suggestive. Due to refractory pain, he was submitted to a popliteal mass excision along with a femoral-posterior tibial bypass. Pathology revealed an epithelioid angiosarcoma. He was referred to a Sarcoma Center, requiring hospitalization for agitation and fever. A positron emission tomography (PET) scan revealed extensive lower limb disease persistence and distant metastases. He died on the 56th day after surgery. To our knowledge, there are only 15 cases of angiosarcoma of the popliteal artery described in the literature. Ours stands out as the first one unrelated to a popliteal aneurysm. Being a highly-aggressive tumor, an early diagnosis is challenging but essential to a successful treatment, warranting the need for suspicion of this neoplasm. An early core biopsy or surgical sample may expedite the diagnosis.
摘要：
上皮样血管肉瘤是一种罕见的高级别血管肿瘤，预后不良。我们介绍了一名抗凝的77岁男子，在上个月有pop/sale静脉血栓形成的病史，抱怨同侧持续性下肢疼痛和跛行。缺少pop/远端脉搏提示动脉多普勒超声（DUS），显示股浅动脉远端血栓形成和pop块。由于DUS无法适当评估动脉壁的完整性，怀疑pop动脉的外膜囊性疾病。计算机断层扫描血管造影和磁共振成像结果也提示。由于顽固性疼痛，他接受了pop肿块切除术以及股骨后胫骨旁路术。病理显示上皮样血管肉瘤。他被转到了一个肉瘤中心,因躁动和发烧而需要住院治疗。正电子发射断层扫描（PET）扫描显示广泛的下肢疾病持续存在和远处转移。他在手术后第56天死亡。据我们所知,文献中只有15例血管肉瘤。我们的表现是第一个与pop动脉瘤无关的动脉瘤。作为一个高度侵袭性的肿瘤，早期诊断具有挑战性，但对成功治疗至关重要，保证有必要怀疑这种肿瘤。早期的核心活检或手术样本可以加快诊断。
