Soft tissue vascular tumors. A flow cytometric DNA analysis

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Abstract
Background. The clinical behavior of soft tissue vascular tumors is difficult to predict on histologic grounds alone. Methods. To assess the usefulness of DNA flow cytometry in predicting the biologic behavior of these tumors, the authors studied 51 soft tissue vascular tumors by DNA flow cytometry of paraffin-embedded tissue. Results. All 20 capillary hemangiomas, one epithelioid hemangioma, two spindle cell hemangioendotheliomas, and two benign hemangiopericytomas had a diploid DNA content. Of the 20 patients with angiosarcomas, their ages ranged from 9–80 years (mean, 44.0 years), and the mean follow-up period was 16.5 months. Ten tumors (including two postmastectomy angiosarcomas) were cutaneous, six were deep soft tissues, and four were from other sites. These tumors were classified histologically into three types: sinusoidal (n = 10), capillary (n = 7), and mixed type (n = 3). Thirteen of the angiosarcomas (65%) were diploid, and seven (35%) were aneuploid. Three patients with angiosarcoma had lung metastases at initial diagnosis, and seven had them later in the course. Nine patients died of their disease within a period of 18 months after the initial diagnosis. All five patients with malignant hemangiopericytoma died of their disease. Three of these lesions had a diploid DNA content, and two had an aneuploid content. Although it was found that all benign and intermediate-grade malignant tumors were diploid, there were no significant correlations among histologic type, DNA ploidy, and clinical outcome in angiosarcomas and malignant hemangiopericytomas. Conclusions. Based on this study, DNA analysis has limited value in predicting the biologic behavior of malignant vascular tumors of the soft tissue.