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The development of periprosthetic malignancy in proximity to an arthroplasty has been a matter of debate since it was first reported in 1978. We report a case of tibial angiosarcoma, an extremely rare malignancy, which developed in proximity to a primary knee arthroplasty performed ten years before. To our knowledge this is the second case ever described around a knee arthroplasty. While implantation of orthopaedic material can induce the development of malignant tumours in experimental animals, the overall incidence of malignancy recorded following arthroplasty in clinical studies does not appear to be increased compared to the control population. Each case of periprosthetic malignancy following arthroplasty must receive attention in order to better understand the underlying pathology and to measure the possibility for an increased risk of development of specific cancer types.