7 Warning Signs and Symptoms of Angiosarcoma You Should Know

Angiosarcoma is a rare and aggressive form of cancer that develops in the lining of blood vessels and lymph vessels. This malignancy can occur anywhere in the body but most commonly affects the skin, breast, liver, and heart. When angiosarcoma affects the heart, it is known as cardiac angiosarcoma, which represents one of the most serious forms of this disease. Understanding the symptoms of angiosarcoma is crucial for early detection and prompt medical intervention.

Because angiosarcoma is uncommon, accounting for less than 1% of all soft tissue sarcomas, many people are unfamiliar with its warning signs. The symptoms can vary significantly depending on the location of the tumor, making diagnosis challenging. This article explores the most important symptoms associated with angiosarcoma to help you recognize potential warning signs and seek appropriate medical care.

1. Skin Discoloration and Lesions

One of the most visible symptoms of angiosarcoma, particularly cutaneous angiosarcoma, is the appearance of abnormal skin changes. These typically manifest as bruise-like lesions that may appear purple, red, or dark in color.

The affected area often starts as a small discolored patch that can be easily mistaken for a common bruise. However, unlike regular bruises that heal and fade over time, angiosarcoma lesions persist and progressively worsen. The discoloration may gradually expand in size and can develop a raised or thickened texture.

These skin changes most commonly occur on the scalp and face, especially in elderly individuals, though they can appear anywhere on the body. The lesions may also develop following radiation therapy in previously treated areas, sometimes appearing years after the original treatment.

2. Swelling and Edema

Localized swelling is a significant symptom of angiosarcoma that occurs when the tumor interferes with normal blood or lymphatic circulation. This swelling, medically termed edema, can affect various parts of the body depending on the tumor’s location.

In cases of breast angiosarcoma, patients may notice unusual swelling of the breast tissue that doesn’t resolve with typical measures. The affected breast may feel heavier than the other and appear visibly enlarged. The swelling can occur without the presence of a distinct lump, making it different from other types of breast cancer.

When angiosarcoma affects the extremities, the arms or legs may become progressively swollen, particularly if the tumor blocks lymphatic drainage. This swelling tends to worsen over time and may be accompanied by a feeling of tightness or heaviness in the affected limb.

3. Chest Pain and Breathing Difficulties

Cardiac angiosarcoma, though extremely rare, produces particularly concerning symptoms related to heart function. Chest pain is one of the hallmark symptoms that should never be ignored.

Patients with cardiac angiosarcoma may experience various types of chest discomfort, ranging from sharp, stabbing pains to dull, persistent aching. The pain may worsen with physical activity or deep breathing. Some individuals describe a sensation of pressure or tightness in the chest area.

Breathing difficulties often accompany chest pain in cardiac angiosarcoma cases. Patients may experience shortness of breath (dyspnea) even during minimal exertion or while at rest. This occurs because the tumor can interfere with the heart’s ability to pump blood effectively or may cause fluid accumulation around the heart or in the lungs. Some people notice they cannot lie flat comfortably and need to prop themselves up with pillows to breathe easier at night.

4. Unexplained Fatigue and Weakness

Persistent, overwhelming fatigue is a common but often overlooked symptom of angiosarcoma. This isn’t the normal tiredness that improves with rest; rather, it’s a deep exhaustion that significantly impacts daily functioning.

The fatigue associated with angiosarcoma stems from multiple factors. The cancer cells consume significant energy and nutrients from the body, leaving less available for normal activities. Additionally, if the tumor affects blood vessels, it can lead to anemia, further contributing to feelings of weakness and tiredness.

Patients often report feeling drained even after a full night’s sleep and may find previously easy tasks becoming exhausting. This generalized weakness may be accompanied by decreased stamina and a reduced ability to concentrate or focus on tasks. The fatigue typically worsens as the disease progresses and doesn’t improve with typical rest or lifestyle modifications.

5. Cardiac Arrhythmias and Palpitations

When angiosarcoma develops in the heart, it can disrupt the organ’s normal electrical conduction system, leading to irregular heartbeats known as arrhythmias. These abnormal heart rhythms represent a serious manifestation of cardiac angiosarcoma.

Patients may experience palpitations, which feel like the heart is racing, fluttering, pounding, or skipping beats. These sensations can occur suddenly and may last from a few seconds to several minutes. Some individuals describe feeling like their heart is beating in their throat or neck.

Arrhythmias can range from relatively benign extra beats to potentially life-threatening rapid or irregular rhythms. Some people may also experience episodes of dizziness, lightheadedness, or even fainting (syncope) when the arrhythmia significantly affects blood flow to the brain. These symptoms warrant immediate medical evaluation, as they may indicate significant cardiac involvement.

6. Bleeding and Hemorrhage

Because angiosarcoma affects blood vessels, bleeding is a characteristic symptom that can manifest in various ways depending on the tumor’s location. The fragile, abnormal blood vessels formed by the tumor are prone to rupture.

Cutaneous angiosarcoma may present with bleeding from skin lesions, either spontaneously or with minor trauma. The affected area may ooze blood or develop bloody crusts. Some patients notice that the lesions bleed easily when touched or during washing.

Internal angiosarcomas can cause more serious hemorrhaging. Cardiac angiosarcoma may lead to bleeding into the pericardial sac (the membrane surrounding the heart), causing cardiac tamponade, a life-threatening condition. Liver angiosarcoma can result in internal bleeding into the abdominal cavity, presenting as sudden abdominal pain and distension. Patients may also experience signs of blood loss such as pale skin, rapid heartbeat, and dizziness.

7. Mass or Lump Formation

The presence of a palpable mass or lump is a direct symptom of angiosarcoma that patients or healthcare providers may detect during examination. The characteristics of these masses vary depending on location and stage of the disease.

In soft tissue angiosarcoma, the lump may initially be small and painless, gradually increasing in size over weeks or months. The mass might feel firm or rubbery to the touch and may be movable or fixed to surrounding tissues. As the tumor grows, it may become more prominent and potentially cause discomfort or pain, especially if it presses on nearby nerves or structures.

Breast angiosarcoma may present as a palpable mass, though it more commonly causes diffuse swelling without a discrete lump. When a mass is present, it may feel different from typical breast tissue and may be associated with skin changes over the area. The tumor can grow rapidly, and patients may notice significant changes in size over a relatively short period.

Main Causes of Angiosarcoma

While the exact cause of angiosarcoma remains unclear in many cases, researchers have identified several risk factors and conditions associated with its development:

Previous Radiation Therapy: One of the most well-established risk factors for angiosarcoma is prior radiation treatment. Radiation-induced angiosarcoma can develop years or even decades after radiation therapy for other cancers, particularly breast cancer. The risk appears to correlate with radiation dose and the time elapsed since treatment.

Chronic Lymphedema: Long-standing swelling of the arms or legs due to lymphatic system damage can increase angiosarcoma risk. This is known as Stewart-Treves syndrome when angiosarcoma develops in chronically swollen limbs, often seen in breast cancer patients who have had lymph nodes removed.

Chemical Exposure: Occupational exposure to certain chemicals has been linked to angiosarcoma development. Vinyl chloride, a chemical used in plastics manufacturing, is a known risk factor for liver angiosarcoma. Arsenic exposure has also been associated with increased risk.

Genetic Factors: While most angiosarcomas are not hereditary, certain genetic conditions may increase susceptibility. Some inherited syndromes that affect blood vessel development or tumor suppressor genes may contribute to angiosarcoma risk, though this remains an area of ongoing research.

Foreign Material: In rare cases, angiosarcoma has been reported to develop in association with foreign materials in the body, such as surgical implants, shrapnel, or other foreign bodies that have been present for extended periods.

Frequently Asked Questions

What is the most common location for angiosarcoma?

Angiosarcoma most commonly affects the skin, particularly the scalp and face in elderly individuals. However, it can also develop in deeper tissues including the breast, liver, heart, and other organs. The location often influences the specific symptoms experienced.

How quickly does angiosarcoma progress?

Angiosarcoma is typically an aggressive cancer that can grow and spread rapidly. The progression rate varies among individuals, but many patients notice symptoms worsening over weeks to months rather than years. Early detection and prompt medical attention are crucial.

Can angiosarcoma be detected through routine screening?

There are no standard screening tests for angiosarcoma in the general population due to its rarity. Detection usually occurs when symptoms prompt medical evaluation or when abnormalities are discovered during imaging for other reasons. People with known risk factors should discuss appropriate monitoring with their healthcare providers.

Is cardiac angiosarcoma more dangerous than other types?

Cardiac angiosarcoma is particularly serious due to its location in a vital organ and the critical nature of symptoms it produces. It often presents at advanced stages because early symptoms may be subtle or attributed to other cardiac conditions. The prognosis for cardiac angiosarcoma is generally poor, making early recognition of symptoms essential.

What should I do if I notice symptoms of angiosarcoma?

If you experience persistent skin lesions, unexplained swelling, chest pain, breathing difficulties, or any other concerning symptoms mentioned in this article, consult a healthcare provider promptly. While these symptoms can have many causes, early medical evaluation is important for accurate diagnosis and timely intervention if angiosarcoma is present.

Can angiosarcoma symptoms be mistaken for other conditions?

Yes, angiosarcoma symptoms often mimic other more common conditions. Skin lesions may be mistaken for bruises or benign growths, cardiac symptoms may resemble heart disease, and breast angiosarcoma can be confused with other breast conditions. This similarity to other conditions can delay diagnosis, which is why persistent or progressive symptoms warrant thorough medical investigation.

References:

• Mayo Clinic – Angiosarcoma
• National Cancer Institute – Angiosarcoma
• National Center for Biotechnology Information – Angiosarcoma
• Johns Hopkins Medicine – Angiosarcoma
• MD Anderson Cancer Center – Angiosarcoma