eISSN: 2084-9869
ISSN: 1233-9687
Polish Journal of Pathology
Current issue Archive Manuscripts accepted About the journal Supplements Abstracting and indexing Subscription Contact Instructions for authors
SCImago Journal & Country Rank
vol. 69
Original paper

Angioinvasion as a factor for predicting aggressive outcome in primary thyroid angiosarcoma: three case reports and literature review

Adela Nechifor-Boilă, Myriam Decaussin-Petrucci, Agota Varga-Ilyés, Laura Chinezu, Cosmin Caraşca, Angela Borda

Pol J Pathol 2018; 69 (1): 53-61
Online publish date: 2018/05/07
View full text
Get citation
JabRef, Mendeley
Papers, Reference Manager, RefWorks, Zotero
We report three primary thyroid angiosarcoma (PTA) cases revealing distinctive morphological features. A systematic literature review completed our analysis to evaluate the most important morphological factors for predicting prognosis in PTAs. Three rare PTA cases were analysed. In addition, we identified 46 previously reported PTAs with available follow-up data to compare morphological features related to prognosis between patients with a favourable versus aggressive outcome. The three PTAs displayed considerable architectural heterogeneity: case 1 presented a well circumscribed tumour, extensively necrotic, with only a few highly pleomorphic vascular proliferation; cases 2 and 3 both exhibited plump epithelioid cells forming rudimentary vascular spaces or solid sheets. Case 3 also presented angioinvasion. Cases 1 and 2 were alive and disease-free at 40 and 73 months following diagnosis, respectively, whereas case 3 died within 14 months. Other significant prognostic factors were highlighted by our review and literature data analysis: increased tumour size (p = 0.042), extrathyroidal extension (p = 0.009), and distant metastases at diagnosis (p = 0.001). Although regarded as highly aggressive, PTA can also be characterised by an unusual favourable outcome. For the first time we highlight the importance of reporting angioinvasion, in cases of PTA, as a possible adverse prognostic factor.

thyroid, angiosarcoma, primary, angioinvasion, prognostic

DeLellis RA, Williams ED. Pathology of the thyroid and parathyroid. In: Pathology and Genetics of Tumors of Endocrine Organs. DeLellis RA, Lyoyd RV, Heitz PU, (eds.). IARC Press, Lyon 2004; 57-66.
Ryska A, Ludvíková M, Szépe P, et al. Epithelioid haemangiosarcoma of the thyroid gland. Report of six cases from a non-Alpine region. Histopathology 2004; 44: 40-46.
Collini P, Barisella M, Renne SL, et al. Epithelioid angiosarcoma of the thyroid gland without distant metastases at diagnosis: report of six cases with a long follow-up. Virchows Arch 2016; 469: 223-232.
Kaur A, Didolkar MS, Thomas A. Angiosarcoma of the thyroid: a case report with review of the literature. Endocr Pathol 2013; 24: 156-161.
Goh SG, Chuah KL, Goh HK, et al. Two cases of epithelioid angiosarcoma involving the thyroid and a brief review of non-Alpine epithelioid angiosarcoma of the thyroid. Arch Pathol Lab Med 2003; 127: E70-E73.
Papotti M, Arrondini M, Tavaglione V, et al. Diagnostic controversies in vascular proliferations of the thyroid gland. Endocr
Pathol 2008; 19: 175-183.
Sapino A, Papotti M, Macri L, et al. Intranodular reactive endothelial hyperplasia in adenomatous goitre. Histopathology 1995; 26: 457-462.
Petronella P, Scorzelli M, Luise R, et al. Primary thyroid angiosarcoma: an unusual localization. World J Surg Oncol 2012; 10: 73.
Kalitova P, Plzak J, Kodet R, et al. Angiosarcoma of the thyroid. Eur Arch Otorhinolaryngol 2009; 266: 903-905.
Couto J, Martins RG, Santos AP, et al. Invasive thyroid angiosarcoma with a favorable outcome. Int J Endocrinol Metab 2014; 12: e15806.
Maiorana A, Collina G, Cesinaro AM, et al. Epithelioid angiosarcoma of the thyroid. Clinicopathological analysis of seven cases from non-Alpine areas. Virchows Arch 1996; 429: 131-137.
Lamovec J, Zidar A, Zidanik B. Epithelioid angiosarcoma of the thyroid gland. Report of two cases. Arch Pathol Lab Med 1994; 118: 642-646.
Altinay S, Ozen A, Namal E, et al. Electron microscopic analysis of an angiosarcoma of the thyroid from a non-Alpine endemic goiter region: A case report and brief review of the literature. Oncol Lett 2014; 8: 2117-2121.
Innaro N, Succurro E, Tomaino G, et al. Nonalpine thyroid angiosarcoma in a patient with hashimoto thyroiditis. Case Rep Oncol Med 2013; 2013: 901246.
Yoon MS, Su PH, Young WJ, et al. Primary thyroid angiosarcoma with tracheal invasion. Intern Med 2016; 55: 1165-1169.
Bayir O, Yilmazer D, Ersoy R, et al. An extremely rare case of thyroid malignancy from the non-Alpine region: Angiosarcoma. Int J Surg Case Rep 2016; 19: 92-96.
Binesh F, Akhavan A, Navabii H, et al. Primary angiosarcoma of the thyroid gland in an young Iranian woman. BMJ Case Rep 2011; 2011: bcr0320114042.
Chan YF, Ma L, Boey JH, et al. Angiosarcoma of the thyroid. An immunohistochemical and ultrastructural study of a case in a Chinese patient. Cancer 1986; 57: 2381-2388.
Eusebi V, Carcangiu ML, Dina R, et al. Keratin-positive epithelioid angiosarcoma of thyroid. A report of four cases. Am
J Surg Pathol 1990; 14: 737-747.
Isa NM, James DT, Saw TH, et al. Primary angiosarcoma of the thyroid gland with recurrence diagnosed by fine needle aspiration: a case report. Diagn Cytopathol 2009; 37: 427-432.
Mills SE, Gaffey MJ, Watts JC, et al. Angiomatoid carcinoma and ‘angiosarcoma’ of the thyroid gland. A spectrum of endothelial differentiation. Am J Clin Pathol 1994; 102: 322-330.
Prather J, Mehrotra S. Thyroid nodule. Primary thyroid angiosarcoma. JAMA Otolaryngol Head Neck Surg 2014; 140: 469-470.
Rotellini M, Vezzosi V, Bianchi S. Epithelioid angiosarcoma of the thyroid: report of a case from an Italian non-alpine area and review of the literature. Endocr Pathol 2015; 26: 152-156.
Tanda F, Massarelli G, Bosincu L, et al. Angiosarcoma of the thyroid: a light, electron microscopic and histoimmunological study. Hum Pathol 1988; 19: 742-745.
Gouveia P, Silva C, Magalhães F, et al. Non-Alpine thyroid angiosarcoma. Int J Surg Case Rep 2013; 4: 524-527.
Astl J, Duskovà J, Limanovà Z, et al. Hemangiosarcoma of the Thyroid Gland. A case report. Neuro Endocrinol Lett 2000; 21: 213-216.
Cutlan RT, Greer JE, Wong FS, et al. Immunohistochemical characterization of thyroid gland angiomatoid tumors. Exp Mol Pathol 2000; 69: 159-164.
Kefeli M, Mete O. An unusual malignant thyroid nodule: coexistence of epithelioid angiosarcoma and follicular variant papillary thyroid carcinoma. Endocr Pathol 2014; 25: 350-352.
Kim NR, Ko YH, Sung CO. A case of coexistent angiosarcoma and follicular carcinoma of the thyroid. J Korean Med Sci 2003; 18: 908-913.
Lin O, Gerhard R, Coelho Siqueira SA, et al. Cytologic findings of epithelioid angiosarcoma of the thyroid. A case report. Acta Cytol 2002; 46: 767-771.
Proces S, Schroeyers P, Delos M, et al. Angiosarcoma of the thyroid and concurrent hyperthyroidism. J Endocrinol Invest 1998; 21: 67-69.
Del RP, Cataldo S, Sommaruga L, et al. A rare case of thyroid haemangiosarcoma. Chir Ital 2007; 59: 747-749.
Fulciniti F, Di MD, Bove P, et al. Fine needle aspiration of metastatic epithelioid angiosarcoma: a report of 2 cases. Acta Cytol 2008; 52: 612-618.
Yilmazlar T, Kirdak T, Adim S, et al. A case of hemangiosarcoma in thyroid with severe anemia due to bone marrow metastasis. Endocr J 2005; 52: 57-59.
Hart J, Mandavilli S. Epithelioid angiosarcoma: a brief diagnostic review and differential diagnosis. Arch Pathol Lab Med 2011; 135: 268-272.
Surov A, Gottschling S, Wienke A, et al. Primary thyroid sarcoma: a systematic review. Anticancer Res 2015; 35: 5185-5191.
Das P, Kotilingam D, Korchin B, et al. High prevalence of p53 exon 4 mutations in soft tissue sarcoma. Cancer 2007; 109: 2323-2333.
Italiano A, Chen CL, Thomas R, et al. Alterations of the p53 and PIK3CA/AKT/mTOR pathways in angiosarcomas: a pattern distinct from other sarcomas with complex genomics. Cancer 2012; 118: 5878-5887.
Quick links
© 2018 Termedia Sp. z o.o. All rights reserved.
Developed by Bentus.
PayU - płatności internetowe