Abstract
Background
Hemarthrosis after total knee arthroplasty (TKA) is a relatively rare complication.
Although most cases are effectively treated with conservative therapy, some cases
require angiographic embolization or surgical intervention. Angiosarcoma is a rare
malignant tumor derived from the vascular endothelium with neovascular hyperplasia
and mainly arises in the skin and superficial soft tissue, and less frequently in
deep soft tissue and bone. Although malignant neoplasms such as angiosarcoma in the
vicinity of orthopedic implants were reported, the causal relationship between development
of the malignant tumor and the orthopedic implant is widely debated in the literature.
Case presentation
We report the case of a 68-year-old female with angiosarcoma that developed in the
knee joint 2 years after revision TKA. The patient exhibited severe persistent bleeding,
which reached 1000–1400 ml per day for 4 months. Histological analysis of the synovial
tissue in the knee joint showed large cells with nuclear atypia. Immunohistochemical
staining showed cells that were positive for CD31, CD34, and D2-40, and she was diagnosed
with angiosarcoma. The patient underwent an amputation at the level of the thigh,
and her general condition immediately improved after the operation. The patient did
not exhibit bleeding from the site of amputation, and no local recurrence or distant
metastases were detected 1 year after the amputation.
Conclusions
To the best of our knowledge, this represents the first report of angiosarcoma 2 years
after revision TKA. Further careful follow up is needed, given the high-grade malignancy.
Keywords
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Article info
Publication history
Published online: December 23, 2020
Accepted:
November 23,
2020
Received in revised form:
November 4,
2020
Received:
May 8,
2020
Identification
Copyright
© 2020 Elsevier B.V. All rights reserved.
