Angiosarcoma is an uncommon malignant neoplasm of vascular or lymphatic endothelium accounting for less than 2% of all soft tissue sarcomas. Only handful of cases with imaging features of angiosarcoma have been described in the literature. These are aggressive tumors that tend to recur locally, spread widely and have high rate of nodal and systemic metastasis and are associated with poor prognosis. Therefore, its essential to accurately stage these cancers for appropriate clinical management. In this exhibit, we aim to highlight the role of PET CT in management of patients with Angiosarcoma.

We retrospectively reviewed 4 PET CT cases over a 2-year period. FDG PET/CT images were reviewed and metabolic activity of each hypermetabolic regions were calculated using maximum standardized uptake value. Correlative and follow up imaging were also reviewed to assess distant spread or detect early recurrence. Comparison and sensitivity/specificity of PET CT findings was also made to other correlative imaging modalities.

Only 4 biopsy proven cases of angiosarcoma at 5 different sites predominantly involving the skin and subcutaneous regions were identified. The sites included scalp, nose, cheek, buttocks and breast. We present a case based pictorial review of these four biopsy proven cases of angiosarcoma with FDG PET/CT and available correlative imaging.

We concluded that FDG PET/CT imaging had increased sensitivity in all biopsy proven cases of angiosarcoma. It is an effective imaging tool in early diagnosis, staging and follow up imaging of angiosarcoma.