Angiosarcoma arising at the site of an interposition saphenous vein graft in an immunosuppressed renal transplanted patient: case report and review of the literature

ABSTRACT

Angiosarcomas are very rare neoplasms of endothelial origin, especially in renal transplanted patients. Only 16 cases of angiosarcoma arising in immunosuppressed renal transplant recipients have been reported in the literature. This includes our case which is unique because it involving an interposition vein graft in a 45 year-old man with chronic renal failure, treated by allograft kidney transplantation, who developed aneurysm proximal to the site of a functioning arteriovenous fistula, underwent excision of aneurysm and interposition vein graft. No specimen was sent for histopathology. He had recurrent swelling at the site of the interposition vein graft in less than six month requiring re-excision and histopathology confirmed the present of epitheliod angiosarcoma. After three months he developed painful mass at the site of the operation. He refused any surgery intervention or change in the immunosuppressive medication. He died five months later from pulmonary metastases. Although angiosarcomas are very rare in immunosuppressed renal transplanted patient a histological examination is indicated at the time of surgical exploration in patient who develop an enlarging mass or aneurysm with unexplained pain at the site of arteriovenous fistula