A Metal-Associated Epithelioid Angiosarcoma: A Case Report and Literature Review.

Angiosarcoma is a rare, aggressive malignancy that accounts for less than 1% of sarcomas of bone. Epithelioid angiosarcoma, a subtype, is characterized by pleomorphic cells with vascular differentiation and commonly arises in deep soft tissues of the extremities. Angiosarcoma associated with orthopedic implants or retained foreign bodies, such as ballistic debris, is exceedingly rare. Here, the authors present the case of epithelioid angiosarcoma in a 54-year-old male with a history of a prior proximal femur ballistic injury and intramedullary nail fixation who was initially misdiagnosed with chronic osteomyelitis.