Intractable Bleeding After Revision Hip Arthroplasty Because of Angiosarcoma: A Report of 2 Cases

Arthur A Ter-Zakarian; David M Joyce; Steven Lyons; Thomas L Bernasek

doi:10.2106/JBJS.CC.22.00293

Intractable Bleeding After Revision Hip Arthroplasty Because of Angiosarcoma: A Report of 2 Cases

JBJS Case Connect. 2023 Apr 18;13(2). doi: 10.2106/JBJS.CC.22.00293. eCollection 2023 Apr 1.

Authors

Arthur A Ter-Zakarian^{1

2}, David M Joyce³, Steven Lyons^{2

4}, Thomas L Bernasek^{2

4}

Affiliations

¹ Foundation for Orthopaedic Research and Education, Tampa, Florida.
² University of South Florida, Morsani College of Medicine, Tampa, Florida.
³ Sarcoma Department, H. Lee Moffitt Cancer and Research Institute, Tampa, Florida.
⁴ Adult Reconstruction, Florida Orthopaedic Institute, Tampa, Florida.

PMID: 37071738
DOI: 10.2106/JBJS.CC.22.00293

Abstract

Case: Two cases of revision total hip arthroplasty (THA) for pseudotumor and infection with persistent postoperative bleeding because of angiosarcoma are presented. After surgery, both patients' health deteriorated because of hypovolemic shock despite transfusion, pressors, embolization, and prothrombotics. Diagnosis was obscure and delayed despite extensive imaging. Standard and computed tomography angiogram were nondiagnostic and did not localize the tumors or bleeding. Repeat surgeries and biopsies requiring special staining ultimately revealed epithelioid angiosarcoma.

Conclusion: A diagnosis of angiosarcoma was etiologic for persistent postoperative bleeding after revision THA and should be considered in such cases.

Publication types

Case Reports
Research Support, Non-U.S. Gov't

MeSH terms

Arthroplasty, Replacement, Hip* / adverse effects
Arthroplasty, Replacement, Hip* / methods
Hemangiosarcoma* / etiology
Hemangiosarcoma* / surgery
Hip Prosthesis*
Humans
Postoperative Hemorrhage
Reoperation