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Bahk WJ, Na SJ, Whang IY, Kim Y, Seo KJ. Aortic Angiosarcoma Manifesting as Multiple Musculoskeletal Metastases: A Case Report. Diagnostics (Basel) 2024; 14:805. [PMID: 38667451 DOI: 10.3390/diagnostics14080805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 04/08/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024] Open
Abstract
Aortic angiosarcomas are rare. Due to its rarity and metastatic presentation, it is difficult to diagnose metastatic aortic angiosarcoma. We describe the clinicopathological and radiologic features of a metastatic aortic angiosarcoma presenting as musculoskeletal metastases. A 59-year-old male patient presented with left thigh pain. Plain radiographs revealed multifocal osteolytic lesions in the left femur shaft. Abdominopelvic computed tomography showed a lobulated osteolytic lesion in the left iliac bone. Magnetic resonance images revealed multifocal soft tissue lesions in the thigh musculature. A positron emission tomography/computed tomography (PET/CT) scan demonstrated multiple foci of increased uptake in the left femur bone, pelvis, left thigh, and calf musculature. Focal increased uptake in the lower abdominal aorta was newly detected. Pelvis biopsy showed tumor cell nests of epithelioid cells. The tumor cells showed vasoformative features. Immunohistochemically, the tumor cells showed positivity for vimentin, CD31, and ERG. The pathologic diagnosis of epithelioid angiosarcoma was established. The origin of the tumor was presumed to be the aorta. This case underscores the importance of PET scans in identifying primary lesions. In terms of the histopathologic diagnosis of biopsy samples with tumor cells exhibiting epithelioid neoplastic morphology, employing appropriate ancillary techniques such as immunocytochemistry with vascular markers may assist in accurately diagnosing metastatic angiosarcoma.
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Affiliation(s)
- Won Jong Bahk
- Department of Orthopedic Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Sae Jung Na
- Department of Radiology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - In Yong Whang
- Department of Radiology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Yongju Kim
- Department of Radiology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Kyung Jin Seo
- Department of Hospital Pathology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
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2
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Yang P, Wu Q, Zhou Y, Li Y. Primary Epithelioid Angiosarcoma of the Jejunal Mesentery Causing Abdominal Bleeding: Case Report and Literature Review. Onco Targets Ther 2024; 17:327-338. [PMID: 38617088 PMCID: PMC11016259 DOI: 10.2147/ott.s453698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 03/12/2024] [Indexed: 04/16/2024] Open
Abstract
Gastrointestinal angiosarcoma is an extremely rare malignant tumor of the digestive tract, characterized by a very poor prognosis, with few patients surviving more than 1 year after diagnosis. This case report describes a 71-year-old female patient with a 3-year history of intermittent abdominal pain and significant exacerbation of abdominal pain and bloating 2 weeks prior to treatment. After surgical treatment, the pathological and immunohistochemical diagnosis was primary epithelioid angiosarcoma of the jejunal mesentery. The patient refused postoperative adjuvant chemotherapy and died 4 months after diagnosis due to widespread systemic metastasis. In addition, this article reviews 38 previously reported cases of primary gastrointestinal angiosarcoma, aiming to further understand angiosarcoma and thus guide clinical practitioners in providing more comprehensive treatment approaches.
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Affiliation(s)
- Peiyuan Yang
- Department of Gastrointestinal Surgery, China-Japan Union Hospital of Jilin University, Changchun, Jilin, 130000, People’s Republic of China
| | - Qiong Wu
- Department of Pathology, China-Japan Union Hospital of Jilin University, Changchun, Jilin, 130000, People’s Republic of China
| | - Yang Zhou
- Department of Gastrointestinal Surgery, China-Japan Union Hospital of Jilin University, Changchun, Jilin, 130000, People’s Republic of China
| | - Yongchao Li
- Department of Gastrointestinal Surgery, China-Japan Union Hospital of Jilin University, Changchun, Jilin, 130000, People’s Republic of China
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3
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Stridh M, Dahlstrand U, Naumovska M, Engelsberg K, Gesslein B, Sheikh R, Merdasa A, Malmsjö M. Functional and molecular 3D mapping of angiosarcoma tumor using non-invasive laser speckle, hyperspectral, and photoacoustic imaging. Orbit 2024:1-11. [PMID: 38591750 DOI: 10.1080/01676830.2024.2331718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 03/12/2024] [Indexed: 04/10/2024]
Abstract
PURPOSE The gold standard for skin cancer diagnosis is surgical excisional biopsy and histopathological examination. Several non-invasive diagnostic techniques exist, although they have not yet translated into clinical use. This is a proof-of-concept study to assess the possibility of imaging an angiosarcoma in the periocular area. METHODS We use laser speckle, hyperspectral, and photoacoustic imaging to monitor blood perfusion and oxygen saturation, as well as the molecular composition of the tissue. The information obtained from each imaging modality was combined in order to yield a more comprehensive picture of the function, as well as molecular composition of a rapidly growing cutaneous angiosarcoma in the periocular area. RESULTS We found an increase in perfusion coupled with a reduction in oxygen saturation in the angiosarcoma. We could also extract the molecular composition of the angiosarcoma at a depth, depicting both the oxygen saturation and highlighting the presence of connective tissue via collagen. CONCLUSIONS We demonstrate the different physiological parameters that can be obtained with the different techniques and how these can be combined to provide detailed 3D maps of the functional and molecular properties of tumors useful in preoperative assessment.
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Affiliation(s)
- Magne Stridh
- Department of Clinical Sciences Lund, Ophthalmology, Lund University, Lund, Sweden
| | - Ulf Dahlstrand
- Department of Clinical Sciences Lund, Ophthalmology, Lund University, Lund, Sweden
| | - Magdalena Naumovska
- Department of Clinical Sciences Lund, Ophthalmology, Lund University, Lund, Sweden
| | - Karl Engelsberg
- Department of Clinical Sciences Lund, Ophthalmology, Lund University, Lund, Sweden
| | - Bodil Gesslein
- Department of Clinical Sciences Lund, Ophthalmology, Lund University, Lund, Sweden
| | - Rafi Sheikh
- Department of Clinical Sciences Lund, Ophthalmology, Lund University, Lund, Sweden
| | - Aboma Merdasa
- Department of Clinical Sciences Lund, Ophthalmology, Lund University, Lund, Sweden
| | - Malin Malmsjö
- Department of Clinical Sciences Lund, Ophthalmology, Lund University, Lund, Sweden
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4
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Vannas C, Escobar M, Österlund T, Andersson D, Mouhanna P, Soomägi A, Molin C, Wennergren D, Fagman H, Ståhlberg A. Treatment Monitoring of a Patient with Synchronous Metastatic Angiosarcoma and Breast Cancer Using ctDNA. Int J Mol Sci 2024; 25:4023. [PMID: 38612833 PMCID: PMC11012383 DOI: 10.3390/ijms25074023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 03/29/2024] [Accepted: 04/02/2024] [Indexed: 04/14/2024] Open
Abstract
Angiosarcoma is a rare and aggressive type of soft-tissue sarcoma with high propensity to metastasize. For patients with metastatic angiosarcoma, prognosis is dismal and treatment options are limited. To improve the outcomes, identifying patients with poor treatment response at an earlier stage is imperative, enabling alternative therapy. Consequently, there is a need for improved methods and biomarkers for treatment monitoring. Quantification of circulating tumor-DNA (ctDNA) is a promising approach for patient-specific monitoring of treatment response. In this case report, we demonstrate that quantification of ctDNA using SiMSen-Seq was successfully utilized to monitor a patient with metastatic angiosarcoma. By quantifying ctDNA levels using 25 patient-specific mutations in blood plasma throughout surgery and palliative chemotherapy, we predicted the outcome and monitored the clinical response to treatment. This was accomplished despite the additional complexity of the patient having a synchronous breast cancer. The levels of ctDNA showed a superior correlation to the clinical outcome compared with the radiological evaluations. Our data propose a promising approach for personalized biomarker analysis to monitor treatment in angiosarcomas, with potential applicability to other cancers and for patients with synchronous malignancies.
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Affiliation(s)
- Christoffer Vannas
- Sahlgrenska Center for Cancer Research, Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden; (M.E.); (T.Ö.); (D.A.); (P.M.); (A.S.); (H.F.)
- Department of Oncology, Sahlgrenska University Hospital, Region Västra Götaland, 41345 Gothenburg, Sweden;
| | - Mandy Escobar
- Sahlgrenska Center for Cancer Research, Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden; (M.E.); (T.Ö.); (D.A.); (P.M.); (A.S.); (H.F.)
| | - Tobias Österlund
- Sahlgrenska Center for Cancer Research, Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden; (M.E.); (T.Ö.); (D.A.); (P.M.); (A.S.); (H.F.)
- Department of Clinical Genetics and Genomics, Sahlgrenska University Hospital, Region Västra Götaland, 41345 Gothenburg, Sweden
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, 40530 Gothenburg, Sweden
| | - Daniel Andersson
- Sahlgrenska Center for Cancer Research, Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden; (M.E.); (T.Ö.); (D.A.); (P.M.); (A.S.); (H.F.)
| | - Pia Mouhanna
- Sahlgrenska Center for Cancer Research, Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden; (M.E.); (T.Ö.); (D.A.); (P.M.); (A.S.); (H.F.)
- Department of Oncology, Ryhov County Hospital, 55185 Jönköping, Sweden
| | - Amanda Soomägi
- Sahlgrenska Center for Cancer Research, Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden; (M.E.); (T.Ö.); (D.A.); (P.M.); (A.S.); (H.F.)
| | - Claes Molin
- Department of Oncology, Sahlgrenska University Hospital, Region Västra Götaland, 41345 Gothenburg, Sweden;
| | - David Wennergren
- Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden;
| | - Henrik Fagman
- Sahlgrenska Center for Cancer Research, Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden; (M.E.); (T.Ö.); (D.A.); (P.M.); (A.S.); (H.F.)
- Department of Clinical Pathology, Sahlgrenska University Hospital, Region Västra Götaland, 41345 Gothenburg, Sweden
| | - Anders Ståhlberg
- Sahlgrenska Center for Cancer Research, Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden; (M.E.); (T.Ö.); (D.A.); (P.M.); (A.S.); (H.F.)
- Department of Clinical Genetics and Genomics, Sahlgrenska University Hospital, Region Västra Götaland, 41345 Gothenburg, Sweden
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, 40530 Gothenburg, Sweden
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5
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Yang Y, Dong Y, Wu J, Li J, Wang Z, Ma Y. Primary Angiosarcoma of the Breast Diagnosed on Core Needle Biopsy: A Diagnostic Challenge. Int J Surg Pathol 2024; 32:368-373. [PMID: 37231624 DOI: 10.1177/10668969231176011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Primary angiosarcoma of the breast is very rare and difficult to pathologically diagnose especially on core needle biopsy. Only 11 cases of breast primary angiosarcoma diagnosed on core needle biopsy have been reported in English literature of last 5 years. We reported a case of primary angiosarcoma of the breast diagnosed on core needle biopsy and summarized the useful morphological clues in literature which prompted the diagnosis of angiosarcoma. A 50-year-old woman presented with a palpable mass in her left breast for a year. She never received breast surgery or radiotherapy before. Microscopically, the core needle biopsy specimen displayed interanastomosing vascular spaces that dissected through the mammary stroma and adipose tissue. The vascular channels were mostly lined by a single layer of endothelial cells with a mild degree of nuclear atypia, whereas focally, the endothelia were multilayered, with tufting and formation of glomerulus-like structures. CD31, CD34, and ERG immunochemical stain highlighted the endothelial cells lining on the vascular spaces. The Ki67 index was about 10%, and MYC was negative. Primary angiosarcomas have significant overlaps of morphological features with benign and borderline vascular lesions. Anastomosing vascular spaces, cytologic atypia, endothelial mitotic activity, infiltration of glandular parenchyma, elevated Ki-67, and high cellularity are all useful clues to diagnose angiosarcomas. Among them, anastomosing vascular spaces with infiltrated growth pattern especially invasion into the breast intralobular stroma and adipose tissue was the most common character of angiosarcomas which alert the possibility of malignancy in core needle biopsy. However, an accurate diagnosis demands integration of various histological clues and multidisciplinary discussion.
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Affiliation(s)
- Ying Yang
- Department of Pathology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yuan Dong
- Department of Breast Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Jian'e Wu
- Department of Pathology, Anning First People's Hospital, Kunming, China
| | - Jun Li
- Department of Radiology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Zhiyuan Wang
- Department of Pathology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yun Ma
- Department of Breast Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming, China
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Tepp JA, Agaram NP, Chang JC, Linos K. Cellular Cutaneous Epithelioid Hemangioma Harboring the Rare GATA6::FOXO1 Gene Fusion. Am J Dermatopathol 2024; 46:223-227. [PMID: 38457669 PMCID: PMC10947873 DOI: 10.1097/dad.0000000000002647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2024]
Abstract
ABSTRACT Epithelioid hemangioma (EH) is a benign vascular tumor displaying diverse histomorphologies. Among these, one EH subtype comprises cellular sheets of atypical epithelioid cells, posing potential challenges in distinguishing it from malignant vascular lesions. In this case report, we present a cutaneous cellular EH that carries the rare GATA6::FOXO1 gene fusion, a recent discovery. Our aim is to provide an updated insight into the evolving knowledge of EHs while delving into the histologic and molecular characteristics of the primary differential diagnoses.
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Affiliation(s)
- Jonathan A. Tepp
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York, USA
| | - Narasimhan P. Agaram
- Department of Pathology & Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Jason C. Chang
- Department of Pathology & Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Konstantinos Linos
- Department of Pathology & Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
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Velasco-Amador JP, Prados-Carmona Á, Navarro-Triviño FJ. If not angioedema, what is it? Diagnostic approach to facial edema. J Dtsch Dermatol Ges 2024; 22:501-512. [PMID: 38483055 DOI: 10.1111/ddg.15336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 11/16/2023] [Indexed: 04/05/2024]
Abstract
Facial edema is a relatively frequent clinical presentation encountered in patients seen in allergology and dermatology clinics. The differential diagnosis is broad, and sometimes the definitive diagnosis can be a challenge for the clinician. Facial angioedema itself encompasses different etiopathologies (histaminergic, bradykinergic, etc.) that must be distinguished from other causes of facial edema, such as allergic contact dermatitis, granulomatous conditions, inflammatory causes, infections, neoplasms or paraneoplastic syndromes, autoimmune diseases, among other entities hereby referred as miscellanea. A proper diagnostic approach is essential to order the appropriate tests, as well as to prescribe a targeted treatment. This review focuses on entities that present with facial edema and summarize their characteristic clinical features.
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Affiliation(s)
| | | | - Francisco José Navarro-Triviño
- Departamento de Eczema de Contacto e Inmunoalergia, Servicio de Dermatología Médico-Quirúrgica y Venereología, Hospital Universitario San Cecilio, Granada, Spain
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8
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Kanatani Y, Mitsui Y, Ogawa K, Takeda M, Miyagawa F, Shinkuma S, Kawaguchi T, Fukumoto T, Asada H. Numerous multinucleated giant cells in cutaneous epithelioid angiosarcoma and pulmonary metastasis: A unique observation with potential diagnostic pitfalls. J Cutan Pathol 2024. [PMID: 38525523 DOI: 10.1111/cup.14614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 02/23/2024] [Accepted: 03/13/2024] [Indexed: 03/26/2024]
Abstract
The histopathologic diagnosis of poorly differentiated cutaneous angiosarcoma can be challenging. We report a case of cutaneous epithelioid angiosarcoma with numerous multinucleated giant cells (MGCs) developing pulmonary metastasis. A 79-year-old man presented with a red-purple plaque on the scalp. A skin biopsy revealed epithelioid cell proliferation, admixed with numerous MGCs, and background hemorrhage. Vascular spaces were focally present and lined by atypical endothelial cells, including MGCs. Immunohistochemically, tumor cells, including MGCs, were positive for CD31, D2-40, and ERG. The patient received radiation therapy and chemotherapy, after which a follow-up CT scan revealed symptomless pneumothorax and pulmonary metastases. The patient received palliative partial lung resection, and the specimen revealed histopathological and immunohistochemical features similar to the primary cutaneous lesion. Our report expands the morphologic spectrum of cutaneous epithelioid angiosarcoma. Cutaneous angiosarcoma is an aggressive neoplasm; thus, awareness of this rare manifestation is important.
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Affiliation(s)
- Yushi Kanatani
- Department of Dermatology, Nara Medical University School of Medicine, Kashihara, Japan
| | - Yasuhiro Mitsui
- Department of Dermatology, Nara Medical University School of Medicine, Kashihara, Japan
- Department of Dermatology, Nara Prefecture General Medical Center, Nara, Japan
| | - Kohei Ogawa
- Department of Dermatology, Nara Medical University School of Medicine, Kashihara, Japan
| | - Maiko Takeda
- Department of Diagnostic Pathology, Nara Medical University School of Medicine, Kashihara, Japan
| | - Fumi Miyagawa
- Department of Dermatology, Nara Medical University School of Medicine, Kashihara, Japan
| | - Satoru Shinkuma
- Department of Dermatology, Nara Medical University School of Medicine, Kashihara, Japan
| | - Takeshi Kawaguchi
- Department of Thoracic and Cardiovascular Surgery, Nara Medical University School of Medicine, Kashihara, Japan
| | | | - Hideo Asada
- Department of Dermatology, Nara Medical University School of Medicine, Kashihara, Japan
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9
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Kohmaru S, Saito Y, Urata M, Imazuru T, Saito K, Shimokawa T, Sakao Y. Successful resection of a primary angiosarcoma of the azygos vein: A case report. Thorac Cancer 2024; 15:575-577. [PMID: 38366805 PMCID: PMC10912536 DOI: 10.1111/1759-7714.15188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 11/28/2023] [Accepted: 11/29/2023] [Indexed: 02/18/2024] Open
Abstract
A 63-year-old woman was admitted to our department for the investigation of superior vena cava (SVC) syndrome. Computed tomography revealed an azygos tumor extending into the SVC. Video-assisted thoracic surgery (VATS) was performed to remove the distal end of the azygos vein in the left lateral position, followed by complete resection of the entire tumor under median sternotomy in the supine position. The histological diagnosis was a primary angiosarcoma of the azygos vein. The patient was discharged without any complications and is now alive and tumor-free 24 months after surgery. In addition, contrast-enhanced computed tomography revealed no graft occlusion in the two reconstructed brachiocephalic veins. Thoracoscopic surgery in the lateral position is useful for safe and reliable complete resection of a tumor arising from the azygos vein.
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Affiliation(s)
- Shinya Kohmaru
- Department of SurgeryTeikyo University School of MedicineTokyoJapan
| | - Yuichi Saito
- Department of SurgeryTeikyo University School of MedicineTokyoJapan
| | - Masahiro Urata
- Department of Cardiovascular SurgeryTeikyo University School of MedicineTokyoJapan
| | - Tomohiro Imazuru
- Department of Cardiovascular SurgeryTeikyo University School of MedicineTokyoJapan
| | - Koji Saito
- Department of PathologyTeikyo University School of MedicineTokyoJapan
| | - Tomoki Shimokawa
- Department of Cardiovascular SurgeryTeikyo University School of MedicineTokyoJapan
| | - Yukinori Sakao
- Department of SurgeryTeikyo University School of MedicineTokyoJapan
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Mota ME, Tomo S, Alves FDA, Pellissari GA, do Nascimento AG, Lopes RN. Gingival metastasis of angiosarcoma of the breast as a first manifestation of spreading disease: Case report and review of the literature. Spec Care Dentist 2024; 44:458-464. [PMID: 37341541 DOI: 10.1111/scd.12896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 06/02/2023] [Accepted: 06/09/2023] [Indexed: 06/22/2023]
Abstract
BACKGROUND Angiosarcoma is an aggressive malignant neoplasm of vascular origin. Oral metastases of angiosarcoma are rare and have a non-specific clinical presentation, thus the diagnosis may be challenging. CASE REPORT Herein we report a case of a 34-year-old female patient after treatment of a high-grade angiosarcoma of the breast, who presented an asymptomatic bleeding purplish nodule in the maxillary interdental papilla between the first and second premolar. A biopsy was performed, and the histological examination revealed infiltration by malignant neoplasm of epithelioid and fusocellular pattern. Immunohistochemical analysis demonstrated that neoplastic cells were positive for ERG and CD31, and negative for cytokeratins AE1/AE3, confirming the diagnosis of metastatic angiosarcoma. After investigation, multiple metastases were discovered. The patient is under management with chemotherapy and palliative radiotherapy for the bone lesions. CONCLUSION Metastases should be considered in the differential diagnosis of oral lesions in patients with a previous history of cancer. Due to the morphology of angiosarcomas, the metastatic lesions may resemble benign vascular lesions, therefore, biopsy is mandatory to exclude malignancy.
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Affiliation(s)
- Maria Emília Mota
- Department of Stomatology, A.C.Camargo Cancer Center, São Paulo, Brazil
| | - Saygo Tomo
- Department of Stomatology, A.C.Camargo Cancer Center, São Paulo, Brazil
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11
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Song Y, Li R, Wang L, Wang H. Case Report: A Rare Case of Primary Angiosarcoma of the Cervix with a Literature Review. Int J Womens Health 2024; 16:265-271. [PMID: 38370343 PMCID: PMC10871135 DOI: 10.2147/ijwh.s439583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 01/22/2024] [Indexed: 02/20/2024] Open
Abstract
Primary angiosarcomas are a rare type of soft-tissue sarcomas that originate from endothelial cells. These sarcomas can develop in any part of the body and have a poor prognosis. However, they are commonly found in the skin of elderly white men, particularly on the scalp and head region. Primary angiosarcoma of the cervix is exceptionally rare. To date, only two cases of this disease have been reported worldwide. The diagnosis of the disease is difficult microscopically, requiring immunohistochemistry and genetic testing to distinguish. We report a recent case, in which the lesion was preoperatively considered a high-grade endometrial stromal sarcoma. A 35-year-old woman presented with vaginal bleeding and cervical erosions. A high-grade endometrial stromal sarcoma involving the cervix was considered and a modified radical hysterectomy was performed with bilateral salpingo-oophorectomy and sentinel lymph nodes resection. The gene diagnosis performed by fluorescence in situ hybridization for YWHAE translocation fusion was negative excluding a YWHAE-translocated high-grade endometrial stromal sarcoma. A primary angiosarcoma of the cervix was finally diagnosed. Primary angiosarcoma of the cervix is rare, and gynecologic pathologists do not know it well, so it is easy to be wrongly considered. Immunohistochemistry and genetic testing help confirm the diagnosis.
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Affiliation(s)
- Yuelin Song
- Department of Obstetrics and Gynecology, West China Second University Hospital of Sichuan University, Chengdu, People’s Republic of China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, People’s Republic of China
| | - Ruizhe Li
- Department of Obstetrics and Gynecology, West China Second University Hospital of Sichuan University, Chengdu, People’s Republic of China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, People’s Republic of China
| | - Lifei Wang
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital Zhejiang University School of Medicine, Yiwu, People’s Republic of China
| | - Hongjing Wang
- Department of Obstetrics and Gynecology, West China Second University Hospital of Sichuan University, Chengdu, People’s Republic of China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, People’s Republic of China
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12
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Dibs K, Gogineni E, Jhawar SM, Baliga S, Grecula JC, Mitchell DL, Palmer J, Haglund K, Andraos TY, Zoller W, Ewing A, Bonomi M, Bhateja P, Tinoco G, Liebner D, Rocco JW, Old M, Gamez ME, Chakravarti A, Konieczkowski DJ, Blakaj DM. Scalp Irradiation with 3D-Milled Bolus: Initial Dosimetric and Clinical Experience. Cancers (Basel) 2024; 16:688. [PMID: 38398079 PMCID: PMC10887235 DOI: 10.3390/cancers16040688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 01/31/2024] [Accepted: 02/04/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND AND PURPOSE A bolus is required when treating scalp lesions with photon radiation therapy. Traditional bolus materials face several issues, including air gaps and setup difficulty due to irregular, convex scalp geometry. A 3D-milled bolus is custom-formed to match individual patient anatomy, allowing improved dose coverage and homogeneity. Here, we describe the creation process of a 3D-milled bolus and report the outcomes for patients with scalp malignancies treated with Volumetric Modulated Arc Therapy (VMAT) utilizing a 3D-milled bolus. MATERIALS AND METHODS Twenty-two patients treated from 2016 to 2022 using a 3D-milled bolus and VMAT were included. Histologies included squamous cell carcinoma (n = 14, 64%) and angiosarcoma (n = 8, 36%). A total of 7 (32%) patients were treated in the intact and 15 (68%) in the postoperative setting. The median prescription dose was 66.0 Gy (range: 60.0-69.96). RESULTS The target included the entire scalp for 8 (36%) patients; in the remaining 14 (64%), the median ratio of planning target volume to scalp volume was 35% (range: 25-90%). The median dose homogeneity index was 1.07 (range: 1.03-1.15). Six (27%) patients experienced acute grade 3 dermatitis and one (5%) patient experienced late grade 3 skin ulceration. With a median follow-up of 21.4 months (range: 4.0-75.4), the 18-month rates of locoregional control and overall survival were 75% and 79%, respectively. CONCLUSIONS To our knowledge, this is the first study to report the clinical outcomes for patients with scalp malignancies treated with the combination of VMAT and a 3D-milled bolus. This technique resulted in favorable clinical outcomes and an acceptable toxicity profile in comparison with historic controls and warrants further investigation in a larger prospective study.
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Affiliation(s)
- Khaled Dibs
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, 460 W. 10th Ave., Columbus, OH 43210, USA; (K.D.); (E.G.); (S.M.J.); (S.B.); (J.C.G.); (D.L.M.); (J.P.); (K.H.); (T.Y.A.); (W.Z.); (A.E.); (A.C.); (D.J.K.)
| | - Emile Gogineni
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, 460 W. 10th Ave., Columbus, OH 43210, USA; (K.D.); (E.G.); (S.M.J.); (S.B.); (J.C.G.); (D.L.M.); (J.P.); (K.H.); (T.Y.A.); (W.Z.); (A.E.); (A.C.); (D.J.K.)
| | - Sachin M. Jhawar
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, 460 W. 10th Ave., Columbus, OH 43210, USA; (K.D.); (E.G.); (S.M.J.); (S.B.); (J.C.G.); (D.L.M.); (J.P.); (K.H.); (T.Y.A.); (W.Z.); (A.E.); (A.C.); (D.J.K.)
| | - Sujith Baliga
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, 460 W. 10th Ave., Columbus, OH 43210, USA; (K.D.); (E.G.); (S.M.J.); (S.B.); (J.C.G.); (D.L.M.); (J.P.); (K.H.); (T.Y.A.); (W.Z.); (A.E.); (A.C.); (D.J.K.)
| | - John C. Grecula
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, 460 W. 10th Ave., Columbus, OH 43210, USA; (K.D.); (E.G.); (S.M.J.); (S.B.); (J.C.G.); (D.L.M.); (J.P.); (K.H.); (T.Y.A.); (W.Z.); (A.E.); (A.C.); (D.J.K.)
| | - Darrion L. Mitchell
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, 460 W. 10th Ave., Columbus, OH 43210, USA; (K.D.); (E.G.); (S.M.J.); (S.B.); (J.C.G.); (D.L.M.); (J.P.); (K.H.); (T.Y.A.); (W.Z.); (A.E.); (A.C.); (D.J.K.)
| | - Joshua Palmer
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, 460 W. 10th Ave., Columbus, OH 43210, USA; (K.D.); (E.G.); (S.M.J.); (S.B.); (J.C.G.); (D.L.M.); (J.P.); (K.H.); (T.Y.A.); (W.Z.); (A.E.); (A.C.); (D.J.K.)
| | - Karl Haglund
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, 460 W. 10th Ave., Columbus, OH 43210, USA; (K.D.); (E.G.); (S.M.J.); (S.B.); (J.C.G.); (D.L.M.); (J.P.); (K.H.); (T.Y.A.); (W.Z.); (A.E.); (A.C.); (D.J.K.)
| | - Therese Youssef Andraos
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, 460 W. 10th Ave., Columbus, OH 43210, USA; (K.D.); (E.G.); (S.M.J.); (S.B.); (J.C.G.); (D.L.M.); (J.P.); (K.H.); (T.Y.A.); (W.Z.); (A.E.); (A.C.); (D.J.K.)
| | - Wesley Zoller
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, 460 W. 10th Ave., Columbus, OH 43210, USA; (K.D.); (E.G.); (S.M.J.); (S.B.); (J.C.G.); (D.L.M.); (J.P.); (K.H.); (T.Y.A.); (W.Z.); (A.E.); (A.C.); (D.J.K.)
| | - Ashlee Ewing
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, 460 W. 10th Ave., Columbus, OH 43210, USA; (K.D.); (E.G.); (S.M.J.); (S.B.); (J.C.G.); (D.L.M.); (J.P.); (K.H.); (T.Y.A.); (W.Z.); (A.E.); (A.C.); (D.J.K.)
| | - Marcelo Bonomi
- Department of Medical Oncology, The Ohio State University Wexner Medical Center, 460 W. 10th Ave., Columbus, OH 43210, USA; (M.B.); (P.B.); (G.T.); (D.L.)
| | - Priyanka Bhateja
- Department of Medical Oncology, The Ohio State University Wexner Medical Center, 460 W. 10th Ave., Columbus, OH 43210, USA; (M.B.); (P.B.); (G.T.); (D.L.)
| | - Gabriel Tinoco
- Department of Medical Oncology, The Ohio State University Wexner Medical Center, 460 W. 10th Ave., Columbus, OH 43210, USA; (M.B.); (P.B.); (G.T.); (D.L.)
| | - David Liebner
- Department of Medical Oncology, The Ohio State University Wexner Medical Center, 460 W. 10th Ave., Columbus, OH 43210, USA; (M.B.); (P.B.); (G.T.); (D.L.)
| | - James W. Rocco
- Department of Otolaryngology, The Ohio State University Wexner Medical Center, 460 W. 10th Ave., Columbus, OH 43210, USA; (J.W.R.); (M.O.)
| | - Matthew Old
- Department of Otolaryngology, The Ohio State University Wexner Medical Center, 460 W. 10th Ave., Columbus, OH 43210, USA; (J.W.R.); (M.O.)
| | - Mauricio E. Gamez
- Department of Radiation Oncology, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA;
| | - Arnab Chakravarti
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, 460 W. 10th Ave., Columbus, OH 43210, USA; (K.D.); (E.G.); (S.M.J.); (S.B.); (J.C.G.); (D.L.M.); (J.P.); (K.H.); (T.Y.A.); (W.Z.); (A.E.); (A.C.); (D.J.K.)
| | - David J. Konieczkowski
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, 460 W. 10th Ave., Columbus, OH 43210, USA; (K.D.); (E.G.); (S.M.J.); (S.B.); (J.C.G.); (D.L.M.); (J.P.); (K.H.); (T.Y.A.); (W.Z.); (A.E.); (A.C.); (D.J.K.)
| | - Dukagjin M. Blakaj
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, 460 W. 10th Ave., Columbus, OH 43210, USA; (K.D.); (E.G.); (S.M.J.); (S.B.); (J.C.G.); (D.L.M.); (J.P.); (K.H.); (T.Y.A.); (W.Z.); (A.E.); (A.C.); (D.J.K.)
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Wu M, Li Z, Luo L, Zhao W, Luo J. Metastatic splenic angiosarcoma presenting with anemia and bone marrow fibrosis mimicking primary myelofibrosis: A case report and literature review. Mol Clin Oncol 2024; 20:16. [PMID: 38274087 PMCID: PMC10809309 DOI: 10.3892/mco.2024.2714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 12/12/2023] [Indexed: 01/27/2024] Open
Abstract
Angiosarcomas, originating from endothelial cells, are infrequent soft tissue sarcomas characterized by a high propensity for metastasis and an unfavorable prognosis. Splenic angiosarcoma, an exceedingly rare and aggressive neoplasm, exhibits variable clinical manifestations. The present case report describes a patient initially exhibiting anemia and bone marrow fibrosis, mimicking primary myelofibrosis, ultimately diagnosed with splenic angiosarcoma. The findings of the present case report underscore the importance of considering splenectomy for histopathological confirmation. Employing a panel of vascular differentiation markers is invaluable for establishing the diagnosis of angiosarcoma.
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Affiliation(s)
- Meiqing Wu
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Zhongqing Li
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Lin Luo
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Weihua Zhao
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Jun Luo
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
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14
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Cortez JL, Elwood H, Matsumoto A. Atypical vascular lesions cleared with Mohs micrographic surgery. JAAD Case Rep 2024; 44:41-43. [PMID: 38292578 PMCID: PMC10824695 DOI: 10.1016/j.jdcr.2023.11.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024] Open
Affiliation(s)
- Jose L. Cortez
- Department of Dermatology, University of New Mexico, Albuquerque, New Mexico
| | - Hillary Elwood
- Department of Dermatopathology, TriCore Reference Laboratories, Albuquerque, New Mexico
| | - Andrew Matsumoto
- Department of Dermatology, University of New Mexico, Albuquerque, New Mexico
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15
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Iwai T, Imagumbai T, Hiraoka S, Kishi T, Okabayashi S, Ashida R, Mitsuyoshi T, Matsuo Y, Ishigaki T, Mizowaki T, Kokubo M. Clinical outcomes of scalp or face angiosarcoma treatment with intensity-modulated radiotherapy: a multicenter study. J Radiat Res 2024; 65:78-86. [PMID: 37996084 PMCID: PMC10803163 DOI: 10.1093/jrr/rrad089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 09/04/2023] [Accepted: 10/10/2023] [Indexed: 11/25/2023]
Abstract
Combined modality therapy, including radiotherapy (RT), is a common treatment for scalp or face angiosarcoma. Although intensity-modulated radiotherapy (IMRT) can deliver homogeneous doses to the scalp or face, clinical data are limited. This multicenter study aimed to evaluate scalp or face angiosarcoma treated with definitive or post-operative IMRT. We retrospectively analyzed data from patients who received IMRT for scalp or face angiosarcoma at three institutions between January 2015 and March 2020. Local control (LC) rate, overall survival (OS), progression-free survival (PFS), recurrence patterns and toxicity were evaluated. Fifteen patients underwent IMRT during the study period. Definitive RT was performed on 10 patients and post-operative RT was performed on 5 patients. The 1-year LC rate was 85.7% (95% confidence interval [CI], 53.9-96.2%). The 1-year OS and PFS rates were 66.7% (95% CI, 37.5-84.6%) and 53.3% (95% CI, 26.3%-74.4%), respectively. Univariate analysis revealed that a clinical target volume over 500 cm3 was associated with poor LC. Distant metastasis was the most common recurrence pattern. All patients experienced Grade 2 or 3 radiation dermatitis, and five patients experienced grade ≥ 3 skin ulceration. One patient who underwent maintenance therapy with pazopanib developed Grade 5 skin ulceration. Fisher's exact test showed that post-operative RT was significantly associated with an increased risk of skin ulceration of grade ≥ 3. These results demonstrate that IMRT is a feasible and effective treatment for scalp or face angiosarcoma, although skin ulceration of grade ≥ 3 is a common adverse event in patients who receive post-operative RT.
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Affiliation(s)
- Takahiro Iwai
- Department of Radiation Oncology, Kobe City Medical Center General Hospital, Minamimachi 21-1, Minatojima, Chuo-ku, Kobe 650-0047, Hyogo, Japan
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawahara-cho, Sakyo-ku, 606-8507, Kyoto, Japan
| | - Toshiyuki Imagumbai
- Department of Radiation Oncology, Kobe City Medical Center General Hospital, Minamimachi 21-1, Minatojima, Chuo-ku, Kobe 650-0047, Hyogo, Japan
| | - Shinya Hiraoka
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawahara-cho, Sakyo-ku, 606-8507, Kyoto, Japan
| | - Takahiro Kishi
- Department of Radiation Oncology, Osaka Red Cross Hospital, 5-30 Fudegasaki-cho, Tennoji-ku, 543-8555, Osaka, Japan
| | - Shun Okabayashi
- Department of Radiation Oncology, Kobe City Medical Center General Hospital, Minamimachi 21-1, Minatojima, Chuo-ku, Kobe 650-0047, Hyogo, Japan
| | - Ryo Ashida
- Department of Radiation Oncology, Kobe City Medical Center General Hospital, Minamimachi 21-1, Minatojima, Chuo-ku, Kobe 650-0047, Hyogo, Japan
| | - Takamasa Mitsuyoshi
- Department of Radiation Oncology, Kobe City Medical Center General Hospital, Minamimachi 21-1, Minatojima, Chuo-ku, Kobe 650-0047, Hyogo, Japan
| | - Yukinori Matsuo
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawahara-cho, Sakyo-ku, 606-8507, Kyoto, Japan
- Department of Radiation Oncology, Faculty of Medicine, Kindai University, 377-2, Ohno-Higashi, Osaka-Sayama, 589-8511, Osaka, Japan
| | - Takashi Ishigaki
- Department of Radiation Oncology, Osaka Red Cross Hospital, 5-30 Fudegasaki-cho, Tennoji-ku, 543-8555, Osaka, Japan
| | - Takashi Mizowaki
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawahara-cho, Sakyo-ku, 606-8507, Kyoto, Japan
| | - Masaki Kokubo
- Department of Radiation Oncology, Kobe City Medical Center General Hospital, Minamimachi 21-1, Minatojima, Chuo-ku, Kobe 650-0047, Hyogo, Japan
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16
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Chung F, Zavadil J. New risk factors and molecular landscapes of hepatic angiosarcoma in the Taiwanese population †. J Pathol 2024; 262:1-3. [PMID: 37929656 DOI: 10.1002/path.6224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 09/26/2023] [Indexed: 11/07/2023]
Abstract
Hepatic angiosarcoma is a rare, highly aggressive malignancy of the liver. The tumorigenesis of hepatic angiosarcoma has been relatively understudied in terms of aetiology and molecular properties. A recent study published in The Journal of Pathology revealed a strong association between hepatic angiosarcoma incidence and chronic kidney disease, particularly in end-stage renal disease using population-based data from the National Health Insurance Research Database in Taiwan and an institutional cohort. The study also revealed enrichment in the mutational signature of aristolochic acid exposure and is the first reported observation of this mutational signature in human sarcomas. © 2023 The Pathological Society of Great Britain and Ireland.
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Affiliation(s)
- Felicia Chung
- Department of Medical Sciences, School of Medical and Life Sciences, Sunway University, Petaling Jaya, Selangor, Malaysia
| | - Jiri Zavadil
- Epigenomics and Mechanisms Branch, International Agency for Research on Cancer WHO, Lyon, Rhône-Alpes, France
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Rahouma M, Baudo M, Khairallah S, Lau C, Gaudino M, El-Sayed Ahmed MM, Kumar A, Lorusso R, Mick SL. Surgically Resected Cardiac Angiosarcoma: Survival Analysis from the National Cancer Database. J Clin Med 2023; 12:7764. [PMID: 38137833 PMCID: PMC10744152 DOI: 10.3390/jcm12247764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/13/2023] [Accepted: 12/15/2023] [Indexed: 12/24/2023] Open
Abstract
Angiosarcoma is a rare type of soft-tissue sarcoma arising from endothelial cells. It is considered 'high-grade' by definition, reflecting its aggressive behavior. We sought to investigate the role of surgery in cardiac angiosarcoma, identify late mortality predictors, and identify interactions with other modalities in its treatment using a national dataset. The 2004-2017 National Cancer Database was reviewed for patients with primary cardiac angiosarcoma. Late mortality predictors were evaluated with Kaplan-Meier curves and Cox regression analysis. Surgery in primary cardiac angiosarcoma was performed in 130 patients (median age 50.5 years; female sex 36.9%). The median follow up was 72.02 months, with a median overall survival (OS) of 14.32 months. In patients treated with surgery in combination with other modalities compared with those treated with surgery alone, median OSs were 17.28 and 2.88 months, respectively (log-rank = 0.018). Older patients (age > 57 years) experienced lower OS compared to those with an age < 57 (log-rank = 0.012). This may be partially explained by the difference in treatment strategies among age groups: those with increasing age, less surgery (p = 0.037), and less chemotherapy (p < 0.001) were chosen. With multivariable Cox regression analysis, age and race other than white or black were identified to be significant independent predictors of late mortality. Cardiac angiosarcoma has poor overall survival, and our findings should further encourage the use of surgery in combination with other therapeutic modalities in treating such an aggressive disease whenever possible.
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Affiliation(s)
- Mohamed Rahouma
- Cardiothoracic Surgery Departments, Weill Cornell Medicine, New York, NY 10065, USA; (M.B.); (S.K.); (C.L.); (M.G.); (S.L.M.)
- Surgical Oncology Department, National Cancer Institute, Cairo University, Cairo 12613, Egypt
| | - Massimo Baudo
- Cardiothoracic Surgery Departments, Weill Cornell Medicine, New York, NY 10065, USA; (M.B.); (S.K.); (C.L.); (M.G.); (S.L.M.)
- Cardiac Surgery Department, Spedali Civili di Brescia, University of Brescia, 25121 Brescia, Italy
| | - Sherif Khairallah
- Cardiothoracic Surgery Departments, Weill Cornell Medicine, New York, NY 10065, USA; (M.B.); (S.K.); (C.L.); (M.G.); (S.L.M.)
- Surgical Oncology Department, National Cancer Institute, Cairo University, Cairo 12613, Egypt
| | - Christopher Lau
- Cardiothoracic Surgery Departments, Weill Cornell Medicine, New York, NY 10065, USA; (M.B.); (S.K.); (C.L.); (M.G.); (S.L.M.)
| | - Mario Gaudino
- Cardiothoracic Surgery Departments, Weill Cornell Medicine, New York, NY 10065, USA; (M.B.); (S.K.); (C.L.); (M.G.); (S.L.M.)
| | - Magdy M. El-Sayed Ahmed
- Cardiothoracic Surgery Department, Mayo Clinic, Jacksonville, FL 55905, USA;
- Department of Surgery, Faculty of Medicine, Zagazig University, Zagazig 44519, Egypt
| | - Akshay Kumar
- Department of Cardiothoracic Surgery, Heart and Lung Transplantation, Mechanical Circulatory Support and ECMO, New York University Langone Health, New York, NY 10016, USA;
| | - Roberto Lorusso
- Department of Cardio-Thoracic Surgery, Maastricht University Medical Centre, Maastricht University, 6211 LK Maastricht, The Netherlands;
- Cardiovascular Research Institute Maastricht, 6229 ER Maastricht, The Netherlands
| | - Stephanie L. Mick
- Cardiothoracic Surgery Departments, Weill Cornell Medicine, New York, NY 10065, USA; (M.B.); (S.K.); (C.L.); (M.G.); (S.L.M.)
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Heishima K, Aketa N, Heishima M, Kawachi A. Hem angiosarcoma in dogs as a potential non-rodent animal model for drug discovery research of angiosarcoma in humans. Front Oncol 2023; 13:1250766. [PMID: 38130992 PMCID: PMC10733437 DOI: 10.3389/fonc.2023.1250766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 11/06/2023] [Indexed: 12/23/2023] Open
Abstract
Since the domestication of dogs 10,000 years ago, they have shared their living environment with humans and have co-evolved. The breeding process that dogs have undergone in only a few centuries has led to a significant accumulation of specific genetic alterations that could induce particular diseases in certain breeds. These canine diseases are similar to what is found in humans with several differences; therefore, comparing such diseases occurring in humans and dogs can help discover novel disease mechanisms, pathways, and causal genetic factors. Human angiosarcoma (AS) and canine hemangiosarcoma (HSA), which are sarcomas originating from endothelium, are examples of diseases shared between humans and dogs. They exhibit similar characteristics and clinical behaviors, although with some critical differences resulting from evolution. In this review, we will describe the similarities and differences in terms of clinical and molecular characteristics between human AS and canine HSA, and discuss how these similarities and differences can be applied to advance the treatment of these diseases.
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Affiliation(s)
- Kazuki Heishima
- Institute for Advanced Study (GUiAS), Gifu University, Gifu, Japan
- Center for One Medicine Innovative Translational Research (COMIT), Gifu University, Gifu, Japan
| | - Naohiko Aketa
- Clinical and Translational Research Center, Keio University Hospital, Tokyo, Japan
| | | | - Asuka Kawachi
- Division of Cancer RNA Research, National Cancer Center, Tokyo, Japan
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
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19
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Evans LK, Sutton S, Echanique K, Armaneous M, Palacios V, Sajed D, St. John M. Cutaneous head and neck angiosarcoma: The 30-year UCLA experience. Laryngoscope Investig Otolaryngol 2023; 8:1557-1563. [PMID: 38130244 PMCID: PMC10731542 DOI: 10.1002/lio2.1173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 10/06/2023] [Indexed: 12/23/2023] Open
Abstract
Background Cutaneous angiosarcoma is an aggressive tumor commonly found in the head and neck region. There is no consensus regarding the definitive treatment for angiosarcoma. Methods This was a retrospective chart review that evaluated 64 patients from 1983 to 2019. Demographic and clinical variables were examined for impact on recurrence using the time to recurrence and the overall survival in Kaplan-Meier curves. Results Average age at diagnosis was 71 (32-95) years, with a 2.8 male: female ratio. Surgery was utilized in 62% of patients, with mean defect size of 11.4 ± 8.1 cm. Recurrence was found in 70% of patients, and mean time to recurrence was 15.3 ± 12.3 months. Decreased recurrence was associated with use of intraoperative frozen section analysis (p = .036) and negative margins (p = .086). Two-year overall survival was 80%, and recurrence free survival was 30%. Conclusions Negative margins are associated with decreased recurrence, and intraoperative frozen section analysis may be considered to obtain preliminary surgical margins.Level of Evidence: 4.
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Affiliation(s)
- Lauran K. Evans
- David Geffen School of Medicine at UCLA—Department of Head & Neck SurgeryLos AngelesCaliforniaUSA
| | - Sarah Sutton
- School of MedicineUniversity of Nevada, RenoRenoNevadaUSA
| | - Kristen Echanique
- David Geffen School of Medicine at UCLA—Department of Head & Neck SurgeryLos AngelesCaliforniaUSA
| | - Michael Armaneous
- David Geffen School of Medicine at UCLA—Department of Head & Neck SurgeryLos AngelesCaliforniaUSA
| | | | - Dipti Sajed
- David Geffen School of Medicine at UCLA—Department of Head & Neck SurgeryLos AngelesCaliforniaUSA
| | - Maie St. John
- David Geffen School of Medicine at UCLA—Department of Head & Neck SurgeryLos AngelesCaliforniaUSA
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Li D, Sun Z, Ma L, Liu S. Recurrence of scalp angiosarcoma after multiple surgeries: A case report and literature review. Oncol Lett 2023; 26:536. [PMID: 38020301 PMCID: PMC10655065 DOI: 10.3892/ol.2023.14122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 09/21/2023] [Indexed: 12/01/2023] Open
Abstract
Scalp angiosarcoma (SA) is rare, accounting for <1% of soft tissue sarcomas, with a high degree of malignancy, a high recurrence rate and a poor prognosis. The best treatment strategy is uncertain. Therefore, it is essential to continuously refine treatment strategies and improve the prognosis of patients. Curative-intent surgery increases overall survival in patients with primary cutaneous angiosarcoma of the scalp and face, and radiation therapy combined with chemotherapy is now recommended for the curative treatment of patients who both can or cannot undergo surgery. The present case report is of an 87-year-old man hospitalised for the fifth time with SA. He had experienced four recurrences and previously underwent curative-intent surgery four times. However, the patient did not undergo radiotherapy or chemotherapy after any of the surgeries. A detailed report of the management of this case is presented along with a review of the relevant literature. It is hypothesised that patients with SA should receive a combination of radiotherapy and chemotherapy after surgery whenever possible, which may improve patient prognosis.
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Affiliation(s)
- Dongjian Li
- Department of Clinical Medicine, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, P.R. China
- Department of Plastic and Burn Surgery, Qilu Hospital of Shandong University, Jinan, Shandong 250012, P.R. China
| | - Zhiguo Sun
- Department of Clinical Medicine, Yanggu County Central Hospital, Liaocheng, Shandong 252300, P.R. China
| | - Ling Ma
- Department of Plastic and Burn Surgery, Qilu Hospital of Shandong University, Jinan, Shandong 250012, P.R. China
| | - Shaohua Liu
- Department of Oral and Maxillofacial Surgery, Qilu Hospital of Shandong University, Jinan, Shandong 250012, P.R. China
- Institute of Stomatology, Shandong University, Jinan, Shandong 250012, P.R. China
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21
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Estabrooks T, Gurinovich A, Pietruska J, Lewis B, Harvey G, Post G, Lambert L, Miller A, Rodrigues L, White ME, Lopes C, London CA, Megquier K. Identification of genomic alterations with clinical impact in canine splenic hem angiosarcoma. Vet Comp Oncol 2023; 21:623-633. [PMID: 37734854 DOI: 10.1111/vco.12925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 07/11/2023] [Accepted: 07/12/2023] [Indexed: 09/23/2023]
Abstract
Canine hemangiosarcoma (HSA) is an aggressive cancer of endothelial cells with short survival times. Understanding the genomic landscape of HSA may aid in developing therapeutic strategies for dogs and may also inform therapies for the rare and aggressive human cancer angiosarcoma. The objectives of this study were to build a framework for leveraging real-world genomic and clinical data that could provide the foundation for precision medicine in veterinary oncology, and to determine the relationships between genomic and clinical features in canine splenic HSA. One hundred and nine dogs with primary splenic HSA treated by splenectomy that had tumour sequencing via the FidoCure® Precision Medicine Platform targeted sequencing panel were enrolled. Patient signalment, weight, metastasis at diagnosis and overall survival time were retrospectively evaluated. The incidence of genomic alterations in individual genes and their relationship to patient variables including outcome were assessed. Somatic mutations in TP53 (n = 44), NRAS (n = 20) and PIK3CA (n = 19) were most common. Survival was associated with presence of metastases at diagnosis and germline variants in SETD2 and NOTCH1. Age at diagnosis was associated with somatic NRAS mutations and breed. TP53 and PIK3CA somatic mutations were found in larger dogs, while germline SETD2 variants were found in smaller dogs. We identified both somatic mutations and germline variants associated with clinical variables including age, breed and overall survival. These genetic changes may be useful prognostic factors and provide insight into the genomic landscape of hemangiosarcoma.
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Affiliation(s)
- Timothy Estabrooks
- Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts, USA
| | | | - Jodie Pietruska
- MassBio, UMass Chan Medical School, Worcester, Massachusetts, USA
| | | | | | - Gerald Post
- One Health Company, Palo Alto, California, USA
| | | | | | | | | | | | - Cheryl A London
- Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts, USA
| | - Kate Megquier
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
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22
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Palmerini E, Reichardt P, Hall KS, Bertulli R, Bielack SS, Comandone A, Egerer G, Hansmeier A, Kevric M, Carretta E, Hansson L, Jebsen N, Eriksson M, Bruland ØS, Donati DM, Ibrahim T, Smeland S, Ferrari S. Outcome of rare primary malignant bone sarcoma treated with multimodal therapy: Results from the EUROpean Bone Over 40 Sarcoma Study (EURO-B.O.S.S.). Cancer 2023; 129:3564-3573. [PMID: 37530385 DOI: 10.1002/cncr.34964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 04/22/2023] [Accepted: 05/17/2023] [Indexed: 08/03/2023]
Abstract
BACKGROUND Rare primary malignant bone sarcomas (RPMBS) account for 5%-10% of primary high-grade bone tumors and represent a major treatment challenge. The outcome of patients with RPMBS enrolled in the EUROpean Bone Over 40 Sarcoma Study (EURO-B.O.S.S) is presented. METHODS Inclusion criteria were as follows: age from 41 to 65 years and a diagnosis of high-grade spindle cell, pleomorphic, or vascular RPMBS. The chemotherapy regimen included doxorubicin 60 mg/m2 , ifosfamide 9 g/m2 , and cisplatin 90 mg/m2 ; postoperative methotrexate 8 g/m2 was added in case of a poor histologic response. Version 2.0 of the Common Terminology Criteria for Adverse Events, Kaplan-Meier curves, log-rank tests, and univariate Cox regression models were used. RESULTS In total, 113 patients were evaluable for analysis. The median patient age was 52 years (range, 40-66 years), and 67 patients were men. Eighty-eight tumors were categorized as undifferentiated pleomorphic sarcomas (UPS), 20 were categorized as leiomyosarcomas, three were categorized as fibrosarcomas, and two were categorized as angiosarcomas. Eighty-three of 113 tumors were located in the extremities. Ninety-five of 113 patients presented with no evidence of metastases. After a median follow-up of 6.8 years (interquartile range [IQR], 3.5-9.8 years), the 5-year overall survival rate for patients with localized disease was 68.4% (IQR, 56.9%-77.5%), and it was 71.7% (IQR, 58.1%-81.6%) for patients with UPS and 54.9% (IQR, 29.5%-74.5%) for patients with leiomyosarcoma. Grade III-IV hematologic toxicity was reported in 81% patients; 23% had grade II-III neurotoxicity, and 37.5% had grade I-II nephrotoxicity. Five-year overall survival was significantly better for patients with localized disease, for patients who obtained surgical complete remission, and when the primary tumor was located in the extremities. CONCLUSIONS The survival of patients who had RPMBS in the current series was similar to that of age-matched patients who had high-grade osteosarcoma treated according to the same protocol. An osteosarcoma-like chemotherapy may be proposed in patients who have RPMBS.
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Affiliation(s)
- Emanuela Palmerini
- Osteoncology, Bone and Soft Tissue Sarcomas, and Innovative Therapies, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Peter Reichardt
- Sarcoma Center, Helios Klinikum Berlin-Buch, Berlin, Germany
| | - Kirsten Sundby Hall
- Department of Oncology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - Rossella Bertulli
- Adult Mesenchymal Tumor Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Stefan S Bielack
- Cooperative Osteosarcoma Study Group, Klinikum Stuttgart-Olgahospital, Stuttgart, Germany
| | - Alessandro Comandone
- SC Oncologia Azienda Sanitaria Locale "Città di Torino" Ospedale San Giovanni Bosco Torino, Turin, Italy
| | | | - Anna Hansmeier
- Department of Hematology and Oncology, University Hospital Münster, Munster, Germany
| | - Matthias Kevric
- Cooperative Osteosarcoma Study Group, Klinikum Stuttgart-Olgahospital, Stuttgart, Germany
| | - Elisa Carretta
- Department of Programming and Monitoring, IRCCS Istituto Ortopedico RizzolI, Bologna, Italy
| | - Lina Hansson
- Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Nina Jebsen
- Haukeland University Hospital, Bergen, Norway
| | | | - Øyvind S Bruland
- Department of Oncology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | | | - Toni Ibrahim
- Osteoncology, Bone and Soft Tissue Sarcomas, and Innovative Therapies, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Sigbjørn Smeland
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Cancer Medicine and Scandinavian Sarcoma Group, Oslo University Hospital, Oslo, Norway
| | - Stefano Ferrari
- Osteoncology, Bone and Soft Tissue Sarcomas, and Innovative Therapies, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
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Alsarraj OM, Alqahtani A, Alswayyed M, Almayouf M, Billa S. Primary Adrenal Angiosarcoma and its Management: A Case Report. Cureus 2023; 15:e48762. [PMID: 38098906 PMCID: PMC10719075 DOI: 10.7759/cureus.48762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2023] [Indexed: 12/17/2023] Open
Abstract
Primary adrenal angiosarcoma is a very rare malignancy. This is a case report of a 54-year-old female, who presented with right-sided abdominal pain. Magnetic resonance imaging of the abdomen and pelvis showed a right adrenal mass with a maximum dimension of 5.7 cm. The patient went for a laparoscopic right adrenalectomy. The postoperative period was uneventful, and she was discharged on postoperative day 2. The patient was free from complaints at outpatient follow-up visits. Pathology confirmed the diagnosis of adrenal angiosarcoma and the metastasis workup was negative. A multidisciplinary approach through the expertise of medical oncology, surgical oncology, and histopathology is essential for the diagnosis and management of such rare diseases.
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Affiliation(s)
- Omar M Alsarraj
- Department of Surgery, Dr. Sulaiman Al-Habib Hospital, Al Takhasussi, SAU
| | | | - Mohammed Alswayyed
- Department of Pathology and Laboratory Medicine, King Saud University, Riyadh, SAU
| | - Mohammad Almayouf
- Department of Surgery, Prince Sattam bin Abdulaziz University, Alkharj, SAU
| | - Srikar Billa
- Department of Surgery, Dr. Sulaiman Al-Habib Hospital, Al Takhasussi, SAU
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24
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Wang WY, Hu SCS, Cheng ST, Lin SY. Polymorphous vessels in angiosarcoma of the scalp: A case report with dermoscopic findings and review of literature. Australas J Dermatol 2023; 64:e371-e374. [PMID: 37431062 DOI: 10.1111/ajd.14129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 06/22/2023] [Indexed: 07/12/2023]
Affiliation(s)
- Wei-Yao Wang
- Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Dermatology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Stephen Chu-Sung Hu
- Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Dermatology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Dermatology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
| | - Shih-Tsung Cheng
- Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Dermatology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Sheng-Yiao Lin
- Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Dermatology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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25
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El Shatanofy M, Thakkar P, Patel V, Joshi A, Goodman J, Siegel R, Haroun F, Ojong-Ntui M, Goyal S, Bauman J, Rao YJ. Intensified Adjuvant Treatment for High-Risk Resected Cutaneous Angiosarcoma of the Head and Neck. Otolaryngol Head Neck Surg 2023; 169:1225-1233. [PMID: 37464928 DOI: 10.1002/ohn.429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 05/10/2023] [Accepted: 05/20/2023] [Indexed: 07/20/2023]
Abstract
OBJECTIVE Previous studies have highlighted the poor survival of patients with cutaneous angiosarcoma of the head and neck. Therapeutic options are limited, and effective treatment strategies are yet to be discovered. The objective of this study is to evaluate overall survival following intensified adjuvant treatment for high-risk resected angiosarcoma of the head and neck. STUDY DESIGN Retrospective observational. SETTING National Cancer Database (NCDB). METHODS Patients diagnosed with nonmetastatic cutaneous angiosarcoma of the head and neck from 2004 to 2016 were identified by NCDB. We retrospectively compared demographics and overall survival between patients who received surgery and radiation therapy (SR) and patients who received surgery and chemoradiation (SRC). The χ2 test, Kaplan-Meier method, and Cox regression models were used to analyze data. RESULTS A total of 249 patients were identified, of which 79.5% were treated with surgery and radiation alone and 20.5% were treated with surgery and chemoradiation. The addition of chemotherapy, regardless of the sequence of administration, was not associated with significantly higher overall survival. Factors associated with worse survival in both groups included positive nodal status and positive margins. Patients with positive nodes had higher overall survival with radiation doses >50.4 Gy compared to ≤50.4 Gy (hazard ratio: 2.93, confidence interval: 1.60-5.36, p < 0.001). CONCLUSION Adjuvant chemotherapy was not significantly associated with higher overall survival for resected nonmetastatic angiosarcoma of the head and neck. Higher radiation doses appear to be prognostic for high-risk diseases.
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Affiliation(s)
- Muhammad El Shatanofy
- Department of Otolaryngology, The George Washington University Hospital, Washington, District of Columbia, USA
- Department of Otolaryngology, University of Miami Hospital, Miami, Florida, USA
| | - Punam Thakkar
- Department of Otolaryngology, The George Washington University Hospital, Washington, District of Columbia, USA
| | - Vishal Patel
- Department of Dermatology, The George Washington University Hospital, Washington, District of Columbia, USA
| | - Arjun Joshi
- Department of Otolaryngology, The George Washington University Hospital, Washington, District of Columbia, USA
| | - Joseph Goodman
- Department of Otolaryngology, The George Washington University Hospital, Washington, District of Columbia, USA
| | - Robert Siegel
- Department of Hematology Oncology, The George Washington University Hospital, Washington, District of Columbia, USA
| | - Faysal Haroun
- Department of Hematology Oncology, The George Washington University Hospital, Washington, District of Columbia, USA
| | - Martin Ojong-Ntui
- Department of Radiation Oncology, The George Washington University Hospital, Washington, District of Columbia, USA
| | - Sharad Goyal
- Department of Radiation Oncology, The George Washington University Hospital, Washington, District of Columbia, USA
| | - Julie Bauman
- Cancer Center, The George Washington University Hospital, Washington, District of Columbia, USA
| | - Yuan James Rao
- Department of Radiation Oncology, The George Washington University Hospital, Washington, District of Columbia, USA
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26
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Assi T, Ibrahim R, Ibrahim T, Khoury R, Cesne AL. Ipilimumab and nivolumab: the 'new kid on the block' in advanced angiosarcoma. Immunotherapy 2023; 15:1089-1091. [PMID: 37585663 DOI: 10.2217/imt-2023-0110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023] Open
Affiliation(s)
- Tarek Assi
- Division of International Patients Care, Gustave Roussy Cancer Campus, Villejuif, France
| | - Rebecca Ibrahim
- Division of International Patients Care, Gustave Roussy Cancer Campus, Villejuif, France
| | - Toni Ibrahim
- Division of International Patients Care, Gustave Roussy Cancer Campus, Villejuif, France
| | - Rita Khoury
- Division of International Patients Care, Gustave Roussy Cancer Campus, Villejuif, France
| | - Axel Le Cesne
- Division of International Patients Care, Gustave Roussy Cancer Campus, Villejuif, France
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27
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Arafat HR, Badawi M, Ramahi M, Fatayer M, Atrash F. Primary cerebral angiosarcoma: a case report. Ann Med Surg (Lond) 2023; 85:5127-5132. [PMID: 37811120 PMCID: PMC10553031 DOI: 10.1097/ms9.0000000000001158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 08/02/2023] [Indexed: 10/10/2023] Open
Abstract
Introduction and importance Central nervous system sarcomas are rare tumors of mesenchymal origin. Angiosarcomas are an even rarer subtype with poor prognosis and no consensus regarding therapeutic approach. Case presentation This article presents the case of a 50-year-old Palestinian female patient with a history of treated breast cancer who presented to the emergency room with a tonic-clonic seizure. Brain computed tomography showed a cerebral space-occupying lesion managed with craniotomy and gross tumor resection. Histopathology revealed an epithelioid cerebral angiosarcoma. The patient was treated with concurrent chemoradiotherapy with temozolomide resulting in the resolution of the tumor as well as symptoms and complaints. Clinical discussion Primary cerebral epithelioid angiosarcoma is a highly malignant tumor of an unknown etiology. The patient history of breast created an additional challenge, as recurrence with metastasis had to be excluded. Signs of blood product degradation are an important radiological feature. According to existing literature, gross tumor resection followed by concurrent chemoradiotherapy offers the best approach and outcome. Conclusion Cerebral angiosarcoma is a rare disease with a challenging therapeutic approach due to the scarcity of available literature. It should be included in the differential diagnosis of space-occupying lesions, especially in those with a history of exposure to radiotherapy. Immunohistochemistry is key for diagnosis. Surgical resection followed by concurrent chemoradiotherapy is associated with a longer disease-free survival when compared to either option alone.
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Affiliation(s)
| | | | | | - Mohammad Fatayer
- Department of Pathology, Augusta Victoria Hospital, Jerusalem, Palestine
| | - Fadi Atrash
- Radiotherapy Unit, Augusta Victoria Hospital
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28
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Lu W, Cao Y, Zeng F, Chen C, Yang Z, Qi Z, Yang X. Surgical Treatment for Benign Lymphangioendothelioma After Two Incomplete Excisions: A Case Report and Literature Review. Clin Cosmet Investig Dermatol 2023; 16:2697-2719. [PMID: 37790904 PMCID: PMC10544170 DOI: 10.2147/ccid.s420019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 09/10/2023] [Indexed: 10/05/2023]
Abstract
Benign lymphangioendothelioma (BL) is a rare, poorly identified, slow-growing benign vascular lesion characterized by asymptomatic, solitary, well-demarcated macules, or by mildly infiltrated plaque. We report a case of an atypical BL that arose as a tender, protuberant, flesh-colored mass with cyanotic vesicles, and then progressed to a persistent exudative wound after two incomplete excisions. The patient was also diagnosed with thoracic duct narrowing. Although the stenosis was removed by surgery, the right lower extremity ulceration and exudation did not improve. Thus, we performed a thorough excision and split-thickness skin graft transplant following vacuum sealing drainage, and eventually the patient had a favorable functional and cosmetic outcome. A biopsy revealed irregular, dilated vascular spaces lined with a single layer of flat endothelial cells extending from the superficial dermis to the subcutis that did not reach the striated muscles. Additionally, by reviewing the literature on BL, in this paper we summarize the diverse pathogenic, morphological, and immunohistochemical presentations for this rare disease, as well as the histopathological differential diagnosis of lymphangiomatosis, Kaposi's sarcoma, and angiosarcoma.
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Affiliation(s)
- Wei Lu
- The Department of Hemangioma and Vascular Malformation, Plastic Surgery Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, People’s Republic of China
| | - Yan Cao
- The Department of Pathology, Plastic Surgery Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, People’s Republic of China
| | - Fanhua Zeng
- The Department of Hemangioma and Vascular Malformation, Plastic Surgery Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, People’s Republic of China
- The Department of Burn and Plastic Surgery, Hengyang No.1 People’s Hospital, Hunan, People’s Republic of China
| | - Chun Chen
- The Department of Hemangioma and Vascular Malformation, Plastic Surgery Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, People’s Republic of China
- E.N.T. Department, Shenzhen Longgang District Third People’s Hospital, Guangdong, People’s Republic of China
| | - Zhenyu Yang
- The Department of Hemangioma and Vascular Malformation, Plastic Surgery Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, People’s Republic of China
| | - Zuoliang Qi
- The Department of Hemangioma and Vascular Malformation, Plastic Surgery Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, People’s Republic of China
| | - Xiaonan Yang
- The Department of Hemangioma and Vascular Malformation, Plastic Surgery Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, People’s Republic of China
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29
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Ribeiro MF, Peretz Soroka H, Bhura Z, Hirsch I, Wunder J, Ferguson P, Tsoi K, Brar S, Gladdy R, Swallow C, Chung P, Catton C, Wong P, Watson G, Razak ARA, Gupta AA, Shultz D. Clinico-demographic characteristics and outcomes of radiation-induced sarcomas (RIS): a CanSaRCC study. Ther Adv Med Oncol 2023; 15:17588359231198943. [PMID: 37781501 PMCID: PMC10540571 DOI: 10.1177/17588359231198943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 08/01/2023] [Indexed: 10/03/2023] Open
Abstract
Background Radiation-induced sarcomas (RIS) tend to have aggressive behaviour and because of their rarity, the most appropriate management for these malignancies is uncertain. Objectives Using the Canadian Sarcoma Research and Clinical Collaboration (CanSaRCC) database, a national sarcoma registry, we aimed to investigate prognostic factors and outcomes for RIS. Design Retrospective study of RIS patients treated from 1996 to 2021 at three Canadian centres. Methods RIS was defined as a sarcoma arising in a previously irradiated field following a 3+ year latency period, whose histology was distinct from the initially irradiated tumour. Clinicopathologic and treatment-related information was extracted from the CanSaRCC database. Overall survival (OS) was defined as the time from RIS diagnosis to death from any cause. Response rate (RR) to neoadjuvant chemotherapy (NACT) was based on physician assessment. Time-to-event analyses were estimated using the Kaplan-Meier method, with Cox regression for multivariate analysis. We considered a two-tailed p-value of <0.05 as statistically significant. Results One hundred seven tumours met the criteria for RIS and were divided into three subgroups: breast angiosarcoma (BAS, n = 54), osteosarcoma (OST, n = 16), and other soft-tissue sarcomas (STS, n = 37). Patients were mostly female (n = 85, 79%), treated initially for breast carcinomas (n = 54, 50.5%), and diagnosed with high-grade tumours (n = 61/71, 86%). None had evidence of synchronous metastasis. Patients with OST were younger (median age: 48 years, p < 0.001), and BAS had the shortest latency interval (8 versus 18 years for OST/STS, p < 0.001). Most patients underwent surgery, 76% (n = 76/100) R0; 24% (n = 26) received radiation therapy, mostly (n = 15, 57.7%) neoadjuvant. Among those receiving chemotherapy, 30 (75%) underwent NACT; among patients with documented response assessment, the RR was 68% (n = 17/25), being even higher in the BAS population (89.5%, n = 13/17). Median OS was 53 months (95% CI 34-101), with a 5-year OS of 47.6%; larger tumour size, high histologic grade and older age were independent prognostic factors for worse OS. Conclusion Surgery is standard, and NACT might be useful to downsize large lesions, especially in BAS patients. Raising RIS awareness is fundamental to promoting appropriate management and fostering research through multi-institutional collaborations.
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Affiliation(s)
- Mauricio Fernando Ribeiro
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, ON, Canada
| | - Hagit Peretz Soroka
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, ON, Canada
| | - Zainab Bhura
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, ON, Canada
| | - Ian Hirsch
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, ON, Canada
| | - Jay Wunder
- Department of Surgery, Mount Sinai Hospital, Sinai Health, Toronto, ON, Canada
- Department of Surgical Oncology, Princess Margaret Cancer Centre, University of Toronto, ON, Canada
| | - Peter Ferguson
- Department of Surgery, Mount Sinai Hospital, Sinai Health, Toronto, ON, Canada
- Department of Surgical Oncology, Princess Margaret Cancer Centre, University of Toronto, ON, Canada
| | - Kim Tsoi
- Department of Surgery, Mount Sinai Hospital, Sinai Health, Toronto, ON, Canada
- Department of Surgical Oncology, Princess Margaret Cancer Centre, University of Toronto, ON, Canada
| | - Savtaj Brar
- Department of Surgery, Mount Sinai Hospital, Sinai Health, Toronto, ON, Canada
| | - Rebecca Gladdy
- Department of Surgery, Mount Sinai Hospital, Sinai Health, Toronto, ON, Canada
- Department of Surgical Oncology, Princess Margaret Cancer Centre, University of Toronto, ON, Canada
| | - Carol Swallow
- Department of Surgery, Mount Sinai Hospital, Sinai Health, Toronto, ON, Canada
- Department of Surgical Oncology, Princess Margaret Cancer Centre, University of Toronto, ON, Canada
| | - Peter Chung
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, ON, Canada
| | - Charles Catton
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, ON, Canada
| | - Philip Wong
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, ON, Canada
| | - Geoffrey Watson
- Division of Medical Oncology, Mount Sinai Hospital, Sinai Health, Toronto, ON, Canada
| | - Albiruni Ryan Abdul Razak
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, ON, Canada
- Division of Medical Oncology, Mount Sinai Hospital, Sinai Health, Toronto, ON, Canada
| | - Abha A. Gupta
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, ON, Canada
| | - David Shultz
- Department of Radiation Oncology, Princess Margaret Cancer Centre – University of Toronto, 610 University Avenue, Toronto, ON M5G 2M9, Canada
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30
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Saiki T, Harada A, Suekane H, Torisu T. Multiple Gastrointestinal Angiosarcoma Mimicking Kaposi's Sarcoma. Intern Med 2023; 62:2577-2578. [PMID: 36575019 PMCID: PMC10518554 DOI: 10.2169/internalmedicine.1177-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 11/20/2022] [Indexed: 12/29/2022] Open
Affiliation(s)
- Takuto Saiki
- Division of Gastroenterology, Yamaguchi Red Cross Hospital, Japan
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Japan
| | - Akira Harada
- Division of Gastroenterology, Yamaguchi Red Cross Hospital, Japan
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Japan
| | - Hiroshi Suekane
- Division of Gastroenterology, Yamaguchi Red Cross Hospital, Japan
| | - Takehiro Torisu
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Japan
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Kobayashi K, Hanai N, Yoshimoto S, Saito Y, Homma A. Current topics and management of head and neck sarcomas. Jpn J Clin Oncol 2023; 53:743-756. [PMID: 37309253 PMCID: PMC10533342 DOI: 10.1093/jjco/hyad048] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 05/18/2023] [Indexed: 06/14/2023] Open
Abstract
Given the low incidence, variety of histological types, and heterogeneous biological features of head and neck sarcomas, there is limited high-quality evidence available to head and neck oncologists. For resectable sarcomas, surgical resection followed by radiotherapy is the principle of local treatment, and perioperative chemotherapy is considered for chemotherapy-sensitive sarcomas. They often originate in anatomical border areas such as the skull base and mediastinum, and they require a multidisciplinary treatment approach considering functional and cosmetic impairment. Moreover, head and neck sarcomas may exhibit different behaviour and characteristics than sarcomas of other areas. In recent years, the molecular biological features of sarcomas have been used for the pathological diagnosis and development of novel agents. This review describes the historical background and recent topics that head and neck oncologists should know about this rare tumour from the following five perspectives: (i) epidemiology and general characteristics of head and neck sarcomas; (ii) changes in histopathological diagnosis in the genomic era; (iii) current standard treatment by histological type and clinical questions specific to head and neck; (iv) new drugs for advanced and metastatic soft tissue sarcomas; and (v) proton and carbon ion radiotherapy for head and neck sarcomas.
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Affiliation(s)
- Kenya Kobayashi
- Department of Otolaryngology–Head and Neck Surgery, University of Tokyo, Tokyo
| | - Nobuhiro Hanai
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya
| | - Seiichi Yoshimoto
- Department of Head and Neck Surgery, National Cancer Center Hospital, Tokyo
| | - Yuki Saito
- Department of Otolaryngology–Head and Neck Surgery, University of Tokyo, Tokyo
| | - Akihiro Homma
- Department of Otolaryngology–Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
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32
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Marconato L, Tiraboschi L, Aralla M, Sabattini S, Melacarne A, Agnoli C, Balboni A, Salvi M, Foglia A, Punzi S, Romagnoli N, Rescigno M. A Phase 2, Single-Arm, Open-Label Clinical Trial on Adjuvant Peptide-Based Vaccination in Dogs with Aggressive Hem angiosarcoma Undergoing Surgery and Chemotherapy. Cancers (Basel) 2023; 15:4209. [PMID: 37686485 PMCID: PMC10486958 DOI: 10.3390/cancers15174209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 08/05/2023] [Accepted: 08/18/2023] [Indexed: 09/10/2023] Open
Abstract
To test the antitumor effect and safety of peptide-based anticancer vaccination in dogs with hemangiosarcoma undergoing the standard of care (SOC; surgery and doxorubicin), canine hemangiosarcoma cells were infected with Salmonella typhi Ty21a to release immunogenic endoplasmic reticulum stress-related peptides into the extracellular milieu via CX43 hemichannels opening. The infected tumor cell secretome constituted the vaccine. Following the SOC, dogs with biologically aggressive hemangiosarcoma were vaccinated a total of five times, once every 3 weeks, and were followed up with serial imaging. A retrospective population of dogs undergoing the SOC alone served as controls. The primary endpoints were the time to progression (TTP) and overall survival (OS), and the secondary endpoints were toxicity and immune responses. A total of 28 dogs were vaccinated along with the SOC, and 32 received only the SOC. A tumor-specific humoral response along with a vaccine-specific T-cell response was observed. Toxicity did not occur. The TTP and OS were significantly longer in vaccinated versus unvaccinated dogs (TTP: 195 vs. 160 days, respectively; p = 0.001; OS: 276 vs. 175 days, respectively; p = 0.002). One-year survival rates were 35.7% and 6.3% for vaccinated and unvaccinated dogs, respectively. In dogs with hemangiosarcoma undergoing the SOC, the addition of a peptide-based vaccine increased the TTP and OS, while maintaining a safe profile. Moreover, vaccinated dogs developed a tumor-specific response, supporting the feasibility of future phase three studies.
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Affiliation(s)
- Laura Marconato
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, Ozzano dell’Emilia, 40064 Bologna, Italy; (S.S.); (C.A.); (A.B.); (A.F.); (S.P.); (N.R.)
| | - Luca Tiraboschi
- IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy; (L.T.); (A.M.); (M.S.); (M.R.)
| | - Marina Aralla
- Pronto Soccorso Veterinario Laudense, 26900 Lodi, Italy;
| | - Silvia Sabattini
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, Ozzano dell’Emilia, 40064 Bologna, Italy; (S.S.); (C.A.); (A.B.); (A.F.); (S.P.); (N.R.)
| | - Alessia Melacarne
- IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy; (L.T.); (A.M.); (M.S.); (M.R.)
| | - Chiara Agnoli
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, Ozzano dell’Emilia, 40064 Bologna, Italy; (S.S.); (C.A.); (A.B.); (A.F.); (S.P.); (N.R.)
| | - Andrea Balboni
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, Ozzano dell’Emilia, 40064 Bologna, Italy; (S.S.); (C.A.); (A.B.); (A.F.); (S.P.); (N.R.)
| | - Marta Salvi
- IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy; (L.T.); (A.M.); (M.S.); (M.R.)
| | - Armando Foglia
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, Ozzano dell’Emilia, 40064 Bologna, Italy; (S.S.); (C.A.); (A.B.); (A.F.); (S.P.); (N.R.)
| | - Sofia Punzi
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, Ozzano dell’Emilia, 40064 Bologna, Italy; (S.S.); (C.A.); (A.B.); (A.F.); (S.P.); (N.R.)
| | - Noemi Romagnoli
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, Ozzano dell’Emilia, 40064 Bologna, Italy; (S.S.); (C.A.); (A.B.); (A.F.); (S.P.); (N.R.)
| | - Maria Rescigno
- IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy; (L.T.); (A.M.); (M.S.); (M.R.)
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy
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Putra J, Agarwal S, Al-Ibraheemi A, Alomari AI, Perez-Atayde AR. Spectrum of Liver Pathology in Dyskeratosis Congenita. Am J Surg Pathol 2023; 47:869-877. [PMID: 37246821 PMCID: PMC10524011 DOI: 10.1097/pas.0000000000002060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Dyskeratosis congenita (DC) is a rare multisystemic disorder associated with defective telomere maintenance. Frequent clinical manifestations of DC include reticular skin pigmentation, dystrophic nails, oral leukoplakia, and bone marrow failure. Hepatic disturbances are reported to occur in 7% of DC patients. This study aimed to evaluate the histopathologic spectrum of hepatic involvement in this disorder. DC patients with liver tissue in the pathology database at Boston Children's Hospital from 1995 to 2022 were identified. Clinical and pathologic information was documented. Thirteen specimens from 11 DC patients were included (M:F = 7:4; median age at the time of liver tissue evaluation: 18 y). DC-associated gene mutations were identified in 9 patients; TERF1-interacting nuclear factor 2 ( TINF2) was the most frequently represented gene mutation, seen in 4 patients. All patients had bone marrow failure, whereas dystrophic nails, cutaneous abnormal pigmentation, and oral leukoplakia were noted in 73%, 64%, and 55% of patients, respectively. Seven patients underwent bone marrow transplants before biopsy/autopsy (median interval of 45 mo). Histologically, 3 of 4 patients who presented with portal hypertension showed noncirrhotic changes (nodular regenerative hyperplasia and/or obliterative portal venopathy), whereas prominent central and sinusoidal fibrosis was noted in patients with intrahepatic shunting and those showing features of chronic passive congestion. All cases showed hepatocyte anisonucleosis. One patient developed hepatic angiosarcoma, and another 1 had colorectal adenocarcinoma metastatic to the liver. DC patients show heterogeneous histologic findings in their liver. The findings of noncirrhotic portal hypertension, intrahepatic shunting, and angiosarcoma suggest vascular functional/structural pathology as a possible unifying etiology of hepatic manifestations of DC.
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Affiliation(s)
| | | | | | - Ahmad I Alomari
- Division of Vascular and Interventional Radiology, Boston Children's Hospital and Harvard Medical School, Boston, MA
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Dermawan JK, Chi P, Tap WD, Rosenbaum E, D'Angelo S, Alektiar KM, Antonescu CR. Distinct genomic landscapes in radiation-associated angiosarcoma compared with other radiation-associated sarcoma histologies. J Pathol 2023; 260:465-477. [PMID: 37350195 PMCID: PMC10756077 DOI: 10.1002/path.6137] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 03/31/2023] [Accepted: 05/05/2023] [Indexed: 06/24/2023]
Abstract
MYC amplifications have been frequently detected in radiation (RT)-associated angiosarcomas (ASs) by low-resolution molecular methods. However, large-scale next-generation sequencing (NGS) studies to investigate the genomic landscape of RT-AS are scarce, particularly compared with other RT-associated sarcomas. We performed a detailed comparative genomic investigation of RT-AS versus other RT-associated histotypes, as well as sporadic sarcomas with similar histologies. Our institutional targeted DNA-NGS assay database was searched for RT-associated sarcomas. Clinical outcome data, pathologic diagnosis, and the types and frequencies of genomic alterations, including single nucleotide variants (SNVs) and copy number alterations (CNAs), were analyzed. The cohort consisted of 82 patients, 68 (83%) females and 14 (17%) males, aged 37-88 (mean 64) years. Forty-four RT-ASs (38 from breast) and 38 RT sarcomas of other histologies, including 12 malignant peripheral nerve sheath tumors (RT-MPNSTs), 14 undifferentiated pleomorphic sarcomas (RT-UPSs), and 12 osteosarcomas (RT-OSs), were included. Median time intervals from radiation to initial diagnosis in RT-AS (8.0 years) were significantly lower than those in RT-MPNST and RT-UPS (12.5 and 18.5 years), respectively. Each RT-sarcoma histotype harbored distinct mutations and CNAs. RT-associated AS had more frequent MYC, FLT4, CRKL, HRAS, and KMT2D alterations than sporadic AS (enriched in TP53, KDR, ATM, ATRX), whereas the mutational landscapes of MPNST, UPS, and OS were similar in both RT and non-RT settings. CDKN2A/B deletions and TP53 alterations were infrequent in RT-AS compared with other RT sarcomas. Among RT sarcomas, RT-AS harbored the lowest fraction of genome altered (FGA), while RT-MPNST showed the highest FGA. RT-AS had the lowest insertion:SNV and deletion:SNV ratios, while RT-UPS had the highest. The predominant mutational signatures were associated with errors in DNA repair and replication. In conclusion, RT-AS has a distinct genomic landscape compared with other RT sarcomas and sporadic AS. Potential molecular targets for precision medicine may be histotype-dependent. © 2023 The Pathological Society of Great Britain and Ireland.
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Affiliation(s)
- Josephine K Dermawan
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Ping Chi
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Medicine, Weill Cornell Medical College, New York, NY, USA
| | - William D Tap
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Evan Rosenbaum
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Sandra D'Angelo
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Kaled M Alektiar
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Cristina R Antonescu
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Skants N, Rönty M, Komulainen O, Keski-Keturi M, Huotari K, Alander-Pekkarinen M, Sihvo M, Laitinen M, Linko R. Case report and review: Angiosarcoma with thrombocytopenia after total hip arthroplasty. Front Surg 2023; 10:1212491. [PMID: 37583390 PMCID: PMC10423994 DOI: 10.3389/fsurg.2023.1212491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 07/11/2023] [Indexed: 08/17/2023] Open
Abstract
Total hip arthroplasty (THA) is a common treatment for osteoarthritis and is also performed for other conditions, such as secondary arthritis due to developmental dysplasia of the hip. Various THA types may be complicated by osteolysis and an inflammatory pseudotumor due to an adverse reaction to metal debris. Rarely, THA has been associated with malignant tumors, but their causality remains unclear. In this case report, we describe a female patient with developmental dysplasia of the hip. She had undergone left metal-on-polyethylene THA, acetabular revision of the THA, and left total knee arthroplasty. In addition, she had a history of dyslipidemia and telangiectasia of the eyes, anemia, hiatal hernia, and pleuritis. A THA-associated mass (suspected to be a pseudotumor) had been detected during a previous hospital admission due to pleuritis. She was hospitalized due to swelling in her left lower limb, fatigue, and bruises. A clinical examination revealed anemia, thrombocytopenia, and growth of the suspected pseudotumor. Within 6 weeks, she presented with bleeding of the oral mucosa, hemoptysis, melena, severe thrombocytopenia that did not respond to treatment, elevated D-dimer and C-reactive protein levels, severe pain, increased osteolysis, and fractures around the THA. Infection or malignancy was suspected, but two trocar biopsies suggested an inflammatory pseudotumor. Since her anemia and thrombocytopenia were considered to have been caused by an inflammatory process within the suspected pseudotumor, her suspected pseudotumor and all THA components were surgically removed. However, she developed severe alveolar hemorrhaging and hypoxia and died 2 weeks after her surgery. Histopathological analysis of her surgical and autopsy samples revealed highly malignant angiosarcoma. Although individual cases of malignancies associated with THA have been reported, the literature lacks a clear association between THA and increased cancer risk. Most pseudotumors are non-malignant. The patient's case presented in this report exemplifies the challenges to the differential diagnosis of a THA-associated pseudotumor and rare angiosarcoma. Atypically rapid tumor growth, severe osteolysis, and deterioration in the general wellbeing suggest a malignant disease.
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Affiliation(s)
- Noora Skants
- Perioperative and Intensive Care, Peijas Hospital, Helsinki University Hospital and University of Helsinki, Vantaa, Finland
| | - Mikko Rönty
- Department of Pathology, HUSLAB, Hospital District of Helsinki and Uusimaa, Diagnostic Center and University of Helsinki, Helsinki, Finland
| | - Olli Komulainen
- Musculoskeletal and Plastic Surgery, Arthroplasty Center, Peijas Hospital, Helsinki University Hospital and University of Helsinki, Vantaa, Finland
| | - Miikka Keski-Keturi
- Emergency Medicine and Services, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Kaisa Huotari
- Department of Infectious Diseases, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Maria Alander-Pekkarinen
- Internal Medicine and Rehabilitation, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Marjut Sihvo
- Internal Medicine and Rehabilitation, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Minna Laitinen
- Musculoskeletal and Plastic Surgery, Bridge Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Rita Linko
- Perioperative and Intensive Care, Peijas Hospital, Helsinki University Hospital and University of Helsinki, Vantaa, Finland
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Niwa M, Tomita N, Takaoka T, Takano H, Makita C, Matsuo M, Adachi S, Oshima Y, Yamamoto S, Kuno M, Miyakawa A, Okazaki D, Torii A, Kita N, Takano S, Nakamura M, Kato H, Morita A, Hiwatashi A. Clinical Outcomes of Radiation Therapy for Angiosarcoma of the Scalp and Face: A Multi-Institutional Observational Study. Cancers (Basel) 2023; 15:3696. [PMID: 37509356 PMCID: PMC10378060 DOI: 10.3390/cancers15143696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 07/17/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
Angiosarcoma of the scalp and face (ASF) is a rare, aggressive tumor often treated with multimodal therapy, including radiation therapy (RT). This study assessed RT outcomes for ASF and identified prognostic factors. Data from 68 non-metastatic ASF patients undergoing RT with or without other therapies were analyzed. Median radiation dose was 66 Gy in 33 fractions (interquartile range (IQR) 60-70 Gy in 28-35 fractions). Local control (LC), progression-free survival (PFS), and overall survival (OS) rates were calculated using Kaplan-Meier analysis. Multivariate analyses and adverse event evaluation were conducted. Median patient age was 75 years (IQR 71-80 years), with a median follow-up of 17 months (IQR 11-42 months). One-/three-year LC rates were 57/37%, PFS rates were 44/22%, and OS rates were 81/44%. Multivariate analyses showed that an equivalent dose in a 2 Gy fraction (EQD2) >66 Gy correlated with improved LC (HR 2.35, 95% CI 1.03-5.32, p = 0.041). Combining chemotherapy (HR 2.43, 95% CI 1.08-5.46, p = 0.032) or surgery (HR 2.41, 95% CI 1.03-5.59, p = 0.041) improved PFS. No factors influenced OS. Late grade 3+ toxicities occurred in 1%, with one patient developing a grade 4 skin ulcer. These findings suggest that EQD2 > 66 Gy and combining chemotherapy or surgery can enhance LC or PFS in ASF. Further prospective studies are needed to determine the optimal treatment strategy for this rare malignancy, particularly in elderly patients.
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Affiliation(s)
- Masanari Niwa
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Japan
| | - Natsuo Tomita
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Japan
| | - Taiki Takaoka
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Japan
| | - Hirota Takano
- Department of Radiation Oncology, Gifu University Hospital, Gifu 500-1194, Japan
| | - Chiyoko Makita
- Department of Radiation Oncology, Gifu University Hospital, Gifu 500-1194, Japan
| | - Masayuki Matsuo
- Department of Radiation Oncology, Gifu University Hospital, Gifu 500-1194, Japan
| | - Sou Adachi
- Department of Radiology, Aichi Medical University Hospital, Nagakute 480-1195, Japan
| | - Yukihiko Oshima
- Department of Radiology, Aichi Medical University Hospital, Nagakute 480-1195, Japan
| | - Shintaro Yamamoto
- Department of Radiology, Japan Community Health Care Organization Chukyo Hospital, Nagoya 457-8510, Japan
| | - Mayu Kuno
- Department of Radiation Oncology, Ichinomiya Municipal Hospital, Ichinomiya 491-8558, Japan
| | - Akifumi Miyakawa
- Department of Radiation Oncology, National Hospital Organization Nagoya Medical Center, Nagoya 460-0001, Japan
| | - Dai Okazaki
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Japan
| | - Akira Torii
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Japan
| | - Nozomi Kita
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Japan
| | - Seiya Takano
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Japan
| | - Motoki Nakamura
- Department of Geriatric and Environmental Dermatology, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Japan
| | - Hiroshi Kato
- Department of Geriatric and Environmental Dermatology, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Japan
| | - Akimichi Morita
- Department of Geriatric and Environmental Dermatology, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Japan
| | - Akio Hiwatashi
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Japan
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37
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Kumari N, Bhandari S, Ishfaq A, Butt SRR, Ekhator C, Karski A, Kadel B, Altayb Ismail MA, Sherpa TN, Al Khalifa A, Khalifah B, Nguyen N, Lazarevic S, Zaman MU, Ullah A, Yadav V. Primary Cardiac Angiosarcoma: A Review. Cureus 2023; 15:e41947. [PMID: 37461430 PMCID: PMC10350284 DOI: 10.7759/cureus.41947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2023] [Indexed: 07/20/2023] Open
Abstract
Primary cardiac angiosarcoma is a rare and aggressive malignancy originating from the endothelial lining of cardiac blood vessels. This review covers various aspects of the disease, including its pathogenesis, clinical presentation, diagnosis, treatment, and prognosis. The primary characteristic of cardiac angiosarcoma is the rapid growth of abnormal blood vessels that invade the heart muscle, leading to the destruction of healthy tissue. Due to its infiltrative nature and early spread, diagnosing and treating cardiac angiosarcoma present significant challenges. Transesophageal echocardiography (TEE) plays a crucial role in diagnosing cardiac tumors such as angiosarcoma due to its high sensitivity. Additional imaging techniques such as computed tomography (CT) and cardiac magnetic resonance imaging (MRI) help assess tumor anatomy and identify metastases. Histopathological examination and immunohistochemistry are essential for confirming the diagnosis, as they reveal distinct histological features and specific endothelial markers associated with primary cardiac angiosarcoma. Targeted therapies directed at the angiogenic mechanisms and molecular abnormalities hold promise for improving treatment outcomes. Early detection of primary cardiac angiosarcoma remains challenging due to its rarity, and the prognosis is generally poor due to advanced disease at the time of diagnosis. The review emphasizes the importance of a multidisciplinary approach and collaboration among different specialties to optimize the diagnosis, treatment, and follow-up care of patients with primary cardiac angiosarcoma. The ultimate goal is to enhance diagnostic methods and therapeutic approaches by advancing knowledge and promoting further research into this aggressive malignancy.
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Affiliation(s)
- Naina Kumari
- Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, PAK
| | | | | | - Samia Rauf R Butt
- General Practice, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Chukwuyem Ekhator
- Neuro-Oncology, New York Institute of Technology College of Osteopathic Medicine, Old Westbury, USA
| | - Amanda Karski
- Emergency Medicine, American University of Antigua, Miami, USA
| | - Bijan Kadel
- Internal Medicine, Nepal Medical College and Teaching Hospital, Kathmandu, NPL
| | | | - Tenzin N Sherpa
- Internal Medicine, Kathmandu University, Nepal Medical College, Kathmandu, NPL
| | - Ahmed Al Khalifa
- Medicine, College of Medicine, Sulaiman Alrajhi University, Al Bukayriyah, SAU
| | | | - Nhan Nguyen
- Internal Medicine, University of Debrecen, Debrecen, HUN
| | | | | | | | - Vikas Yadav
- Internal Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, IND
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Kim YM, Kitlinska JB. Editorial: Women in pediatric oncology Vol II: 2022. Front Oncol 2023; 13:1223296. [PMID: 37434976 PMCID: PMC10332160 DOI: 10.3389/fonc.2023.1223296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 06/06/2023] [Indexed: 07/13/2023] Open
Affiliation(s)
- Yong-mi Kim
- Children’s Hospital Los Angeles, Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Joanna B. Kitlinska
- Biochemistry and Molecular & Cellular Biology, Georgetown University, Washington, DC, United States
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Jhuang JY, Liu CY, Tseng MH, Chuang SS. Cytological Features of a Metastatic Angiosarcoma in the Lymph Node Diagnosed via Liquid-Based Cytology. Diagnostics (Basel) 2023; 13:2124. [PMID: 37371020 DOI: 10.3390/diagnostics13122124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/11/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
Angiosarcoma is a soft tissue sarcoma of vascular origin, with more than half of the cases arising in the skin and affecting primarily the face and scalp of elderly males. Furthermore, cutaneous angiosarcoma exhibits a higher incidence of lymph node metastases than other types of sarcomas. Angiosarcomas are rarely aspirated and are occasionally encountered on cytological samples. It is a diagnostic challenge in evaluating fine needle aspiration (FNA) from a metastatic angiosarcoma without the knowledge of prior history. We present a case of scalp angiosarcoma with disease progression to erythroderma and cervical lymphadenopathy 20 months after. FNA of the cervical node revealed vasoformative features, including hemophagocytosis, formation of an intracytoplasmic lumen/vacuole, endothelial wrapping, and cell grasping. The diagnosis of nodal metastasis by angiosarcoma was confirmed with immunohistochemistry (IHC) using two vascular markers on cell block sections. Our case demonstrates the recognizable cytomorphologic clues for this rare metastatic malignancy.
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Affiliation(s)
- Jie-Yang Jhuang
- Department of Pathology, Mackay Memorial Hospital, New Taipei City 251, Taiwan
| | - Chih-Yi Liu
- Division of Pathology, Sijhih Cathay General Hospital, New Taipei City 221, Taiwan
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 221, Taiwan
| | - Min-Hui Tseng
- Department of Pathology, Chi-Mei Medical Center, Tainan 710, Taiwan
| | - Shih-Sung Chuang
- Department of Pathology, Chi-Mei Medical Center, Tainan 710, Taiwan
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Yoder AK, Farooqi AS, Wernz C, Subramaniam A, Ravi V, Goepfert R, Sturgis EM, Mitra D, Bishop AJ, Guadagnolo BA. Outcomes after definitive treatment for cutaneous angiosarcomas of the face and scalp: Reevaluating the role of surgery and radiation therapy. Head Neck 2023. [PMID: 37272774 DOI: 10.1002/hed.27418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 05/12/2023] [Accepted: 05/15/2023] [Indexed: 06/06/2023] Open
Abstract
INTRODUCTION We investigated outcomes and prognostic factors for patients treated for cutaneous angiosarcoma (CA). METHODS We conducted a retrospective review of patients treated for CA of the face and scalp from 1962 to 2019. All received definitive treatment with surgery, radiation (RT), or a combination (S-XRT). The Kaplan-Meier method was used to estimate outcomes. Multivariable analyses were conducted using the Cox proportional hazards model. RESULTS For the 143 patients evaluated median follow-up was 33 months. Five-year LC was 51% and worse in patients with tumors >5 cm, multifocal tumors, those treated pre-2000, and with single modality therapy (SMT). These remained associated with worse LC on multivariable analysis. The 5-year disease-specific survival (DSS) for the cohort was 56%. Tumor size >5 cm, non-scalp primary site, treatment pre-2000, and SMT were associated with worse DSS. CONCLUSION Large or multifocal tumors are negative prognostic factors in patients with head and neck CA. S-XRT improved outcomes.
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Affiliation(s)
- A K Yoder
- Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas, USA
| | - A S Farooqi
- Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas, USA
| | - C Wernz
- Baylor College of Medicine, Houston, Texas, USA
| | - A Subramaniam
- Department of Sarcoma Medical Oncology, MD Anderson Cancer Center, Houston, Texas, USA
| | - V Ravi
- Department of Sarcoma Medical Oncology, MD Anderson Cancer Center, Houston, Texas, USA
| | - R Goepfert
- Department of Head and Neck Surgery, MD Anderson Cancer Center, Houston, Texas, USA
| | - E M Sturgis
- Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, USA
| | - D Mitra
- Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas, USA
| | - A J Bishop
- Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas, USA
| | - B A Guadagnolo
- Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas, USA
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Pimentel PAB, Giuliano A, Bęczkowski PM, Horta RDS. Molecular Profile of Canine Hem angiosarcoma and Potential Novel Therapeutic Targets. Vet Sci 2023; 10:387. [PMID: 37368773 DOI: 10.3390/vetsci10060387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 05/31/2023] [Accepted: 06/02/2023] [Indexed: 06/29/2023] Open
Abstract
Canine hemangiosarcoma (HSA) is a relatively common neoplasia, occurring mainly in the skin, spleen, liver and right atrium. Despite the numerous studies investigating the treatment of canine HSA, no significant improvement in survival has been achieved in the last 20 years. Advancements in genetic and molecular profiling presented molecular similarities between canine HSA and human angiosarcoma. It could therefore serve as a valuable model for investigating new and more effective treatments in people and dogs. The most common genetic abnormalities in canine HSA have been found in the phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA) and neuroblastoma RAS viral oncogene homolog (NRAS) pathways. Mutations are also found in tumor protein p53 (TP53), phosphatase and tensin homolog (PTEN) and cyclin dependent kinase inhibitor 2A (CDKN2A). Known abnormal protein expression could be exploited to trial new target treatments that could be beneficial for both canine and human patients. Despite the high expression of vascular endothelial growth factor (VEGF) and its receptor (VEGFR), no correlation with overall survival time has ever been found. In this review, we explore the most recent developments in molecular profiling in canine HSA and discuss their possible applications in the prognosis and treatment of this fatal disease.
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Affiliation(s)
| | - Antonio Giuliano
- Department of Veterinary Clinical Science, Jockey Club College of Veterinary Medicine, City University of Hong Kong, Hong Kong, China
- Veterinary Medical Centre, City University of Hong Kong, Hong Kong, China
| | - Paweł Marek Bęczkowski
- Department of Veterinary Clinical Science, Jockey Club College of Veterinary Medicine, City University of Hong Kong, Hong Kong, China
| | - Rodrigo Dos Santos Horta
- Department of Veterinary Clinic and Surgery, Federal University of Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
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Huang SC, Chang IYF, Chang CJ, Liu H, Chen KH, Liu TT, Hsieh TY, Chuang HC, Chen CC, Lin IC, Ng KF, Huang HY, Chen TC. Association between hepatic angiosarcoma and end-stage renal disease: nationwide population-based evidence and enriched mutational signature of aristolochic acid exposure. J Pathol 2023; 260:165-176. [PMID: 36815532 DOI: 10.1002/path.6072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 01/31/2023] [Accepted: 02/20/2023] [Indexed: 02/24/2023]
Abstract
Hepatic angiosarcoma (HAS) is an aggressive mesenchymal malignancy that remains underexplored with respect to its etiology and mutational landscapes. To clarify the association between HAS and end-stage renal disease (ESRD), we used nationwide data of the National Health Insurance Research Database (NHIRD) in Taiwan, covering ~99% of the population, from 2001 to 2016. To investigate molecular signatures, we performed whole-exome sequencing (WES) in 27 surgical specimens, including nine ESRD-associated cases. The NHIRD analysis demonstrated that HAS ranked second among all angiosarcomas in Taiwan, with the incidence rates of HAS being 0.08, 2.49, and 5.71 per 100,000 person-years in the general population, chronic kidney disease (CKD), and ESRD patients, respectively. The standardized incidence ratios of HAS in CKD and ESRD patients were 29.99 and 68.77, respectively. In comparison with nonhepatic angiosarcoma, the multivariate regression analysis of our institutional cohort confirmed CKD/ESRD as an independent risk factor for HAS (odds ratio: 9.521, 95% confidence interval: 2.995-30.261, p < 0.001). WES identified a high tumor mutation burden (TMB; median: 8.66 variants per megabase) and dominant A:T-to-T:A transversion in HAS with frequent TP53 (81%) and ATRX (41%) mutations, KDR amplifications/gains (56%), and CDKN2A/B deletions (48%). Notably, ESRD-associated HAS had a significantly higher TMB (17.62 variants per megabase, p = 0.01) and enriched mutational signatures of aristolochic acid exposure (COSMIC SBS22, p < 0.001). In summary, a significant proportion of HAS in Taiwan is associated with ESRD and harbors a distinctive mutational signature, which concomitantly links nephrotoxicity and mutagenesis resulting from exposure to aristolochic acid or related compounds. A high TMB may support the eligibility for immunotherapy in treating ESRD-associated HAS. © 2023 The Pathological Society of Great Britain and Ireland.
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Affiliation(s)
- Shih-Chiang Huang
- Department of Anatomic Pathology, Linkou Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan, Taiwan
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ian Yi-Feng Chang
- Molecular Medicine Research Center, Chang Gung University, Taoyuan, Taiwan
- Department of Neurosurgery, Linkou Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan, Taiwan
| | - Chee-Jen Chang
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Research Services Center for Health Information, Chang Gung University, Taoyuan, Taiwan
- Clinical Informatics and Medical Statistics Research Center, Chang Gung University, Taoyuan, Taiwan
- Department of Biomedical Sciences, Chang Gung University, Taoyuan, Taiwan
- Department of Cardiology, Linkou Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan, Taiwan
| | - Hsuan Liu
- Molecular Medicine Research Center, Chang Gung University, Taoyuan, Taiwan
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Cell and Molecular Biology, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Kuang-Hua Chen
- Department of Anatomic Pathology, Linkou Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan, Taiwan
| | - Ting-Ting Liu
- Department of Anatomical Pathology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Kaohsiung, Taiwan
- Department of Medical Laboratory Science, I-Shou University, Kaohsiung, Taiwan
| | - Tsan-Yu Hsieh
- Department of Anatomic Pathology, Keelung Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Keelung, Taiwan
| | - Huei-Chieh Chuang
- Department of Anatomic Pathology, Chiayi Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Chiayi, Taiwan
| | - Chien-Cheng Chen
- Department of Radiology, Linkou Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan, Taiwan
| | - I-Chieh Lin
- Department of Anatomic Pathology, Linkou Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan, Taiwan
| | - Kwai-Fong Ng
- Department of Anatomic Pathology, Linkou Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan, Taiwan
| | - Hsuan-Ying Huang
- Department of Anatomical Pathology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Kaohsiung, Taiwan
| | - Tse-Ching Chen
- Department of Anatomic Pathology, Linkou Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan, Taiwan
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Noman M, Zeer AM, Zeer ZM, Daas R, Hamamra Y. Epithelioid angiosarcoma of the adrenal gland with metastasis: a case report and literature review. Ann Med Surg (Lond) 2023; 85:3106-3112. [PMID: 37363587 PMCID: PMC10289494 DOI: 10.1097/ms9.0000000000000789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 05/01/2023] [Indexed: 06/28/2023] Open
Abstract
Primary adrenal epithelioid angiosarcoma is an exceptionally rare condition, with only 51 cases reported in the literature since 1988. Case presentation We report a case of a 59-year-old male patient who presented with a 4-month history of left flank pain and anemia. Radiographic imaging identified a 14 cm mass lesion in the left suprarenal region, which showed heterogeneous enhancement. The patient underwent total adrenalectomy with tumor-free surgical margins. Histological sections showed features consistent with an epithelioid tumor, and immunohistochemical staining confirmed the diagnosis of epithelioid angiosarcoma of the left adrenal gland. Discussion Primary adrenal epithelioid angiosarcoma is a very rare entity. It was first described by Kareti et al. in 1998. The most common presentation is an abdominal mass associated with pain. As there are no specific imaging findings for this tumor, histology combined with immunohistochemistry is the most definitive diagnostic method. Surgery with adjuvant chemotherapy is the management reported for previous cases. Conclusion In cases of rare malignancies, interdisciplinary collaboration is crucial for determining the optimal management strategy.
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Affiliation(s)
| | | | | | - Raed Daas
- Augusta Victoria Hospital, Jerusalem, Palestine
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Guo Y, Liu Q, Wu H. Primary cardiac tumor: a case report of right atrial angiosarcoma and review of the literature. Front Oncol 2023; 13:1164153. [PMID: 37305576 PMCID: PMC10250602 DOI: 10.3389/fonc.2023.1164153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 05/11/2023] [Indexed: 06/13/2023] Open
Abstract
Primary cardiac angiosarcoma is a relatively rare tumor with early metastasis and poor prognosis. Radical resection of the primary tumor remains the primary approach for the optimal survival of patients with early-stage cardiac angiosarcoma without evidence of metastasis. This case involves a 76-year-old man with symptoms of chest tightness, fatigue, pericardial effusion, and arrhythmias who achieved good results after surgery to treat the angiosarcoma in the right atrium. In addition, literature analysis showed that surgery remains an effective way of treating primary early angiosarcoma.
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Affiliation(s)
- Yujian Guo
- Department of Changzhi People's Hospital, The Affiliated Hospital of Changzhi Medical College, Changzhi, Shanxi, China
| | - Qianzhen Liu
- Department of Pathology, The First People’s Hospital of Foshan, Foshan, Guangdong, China
| | - Haibo Wu
- Department of Cardiothoracic Surgery, Changzhi People’s Hospital, Changzhi, Shanxi, China
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Apalla Z, Liopyris K, Kyrmanidou E, Fotiadou C, Sgouros D, Patsatsi A, Trakatelli MG, Kalloniati E, Lallas A, Lazaridou E. Clinical and Dermoscopic Characteristics of Cutaneous Sarcomas: A Literature Review. Diagnostics (Basel) 2023; 13:diagnostics13101822. [PMID: 37238306 DOI: 10.3390/diagnostics13101822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/18/2023] [Accepted: 05/19/2023] [Indexed: 05/28/2023] Open
Abstract
Under the umbrella of cutaneous sarcomas (CS) we include a heterogeneous group of rare, malignant, mesenchymal neoplasia, such as dermatofibrosarcoma protuberans, atypical fibroxanthoma, cutaneous undifferentiated pleomorphic sarcoma, cutaneous angiosarcoma and leiomyosarcoma. Clinical presentation and histopathological examination are the cornerstone of CS diagnosis and classification. There are scarce data in the literature in regards to the clinical and dermatoscopic characteristics of CS and the role of dermatoscopy in their early identification. We performed a literature review, aiming to summarize current data on the clinical and dermatoscopic presentation of the most common types of cutaneous sarcomas that may facilitate early diagnosis and prompt management. Based on the available published data, CS are characterized by mostly unspecific dermatoscopic patterns. Dermatofibrosarcoma protuberans, Kaposi's sarcoma, and in a lesser degree, cutaneous angiosarcoma, may display distinct dermatoscopic features, facilitating their early clinical recognition. In conclusion, dermatoscopy, in conjunction with the overall clinical context, may aid towards suspicion of CS.
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Affiliation(s)
- Zoe Apalla
- Second Dermatology Department, Aristotle University of Thessaloniki, 55535 Thessaloniki, Greece
| | - Konstantinos Liopyris
- First Dermatology Department, National and Kapodistrian University of Athens, 16121 Athens, Greece
| | - Eirini Kyrmanidou
- Second Dermatology Department, Aristotle University of Thessaloniki, 55535 Thessaloniki, Greece
| | - Christina Fotiadou
- Second Dermatology Department, Aristotle University of Thessaloniki, 55535 Thessaloniki, Greece
| | - Dimitrios Sgouros
- Second Dermatology Department, National and Kapodistrian University of Athens, 16121 Athens, Greece
| | - Aikaterini Patsatsi
- Second Dermatology Department, Aristotle University of Thessaloniki, 55535 Thessaloniki, Greece
| | | | - Evangelia Kalloniati
- Second Dermatology Department, Aristotle University of Thessaloniki, 55535 Thessaloniki, Greece
| | - Aimilios Lallas
- First Dermatology Department, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Elizabeth Lazaridou
- Second Dermatology Department, Aristotle University of Thessaloniki, 55535 Thessaloniki, Greece
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Ariyaratne S, Jenko N, Iyengar KP, James S, Mehta J, Botchu R. Primary Osseous Malignancies of the Spine. Diagnostics (Basel) 2023; 13:diagnostics13101801. [PMID: 37238285 DOI: 10.3390/diagnostics13101801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 05/15/2023] [Accepted: 05/17/2023] [Indexed: 05/28/2023] Open
Abstract
Malignant primary vertebral tumours comprise an uncommon group of primary bone malignancies that can pose a diagnostic and therapeutic challenge. The most frequently encountered malignant primary vertebral tumours include chordoma, chondrosarcoma, Ewing sarcoma and osteosarcoma. These tumours often present with nonspecific symptoms, such as back pain, neurologic deficits and spinal instability, which can be confused for the more commonly encountered mechanical back pain and may delay their diagnosis and treatment. Imaging, including radiography, computed tomography (CT) and magnetic resonance imaging (MRI) is crucial for diagnosis, staging, treatment planning and follow-up. Surgical resection remains the mainstay of treatment for malignant primary vertebral tumours, but adjuvant radiotherapy and chemotherapy may be necessary for achieving complete tumour control depending on the type of tumour. In recent years, advances in imaging techniques and surgical approaches, such as en-bloc resection and spinal reconstruction, have improved the outcomes for patients with malignant primary vertebral tumours. However, the management can be complex due to the anatomy involved and the high morbidity and mortality associated with surgery. The different types of malignant primary vertebral lesions will be discussed in this article with an emphasis on the imaging features.
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Affiliation(s)
| | - Nathan Jenko
- Royal Orthopaedic Hospital, Birmingham B31 2AP, UK
| | | | - Steven James
- Royal Orthopaedic Hospital, Birmingham B31 2AP, UK
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Li J, Li Y, Wang Y, Li Z, Zhang H, Gao Y, Tan J. Clinicopathological characteristics and survival outcomes in patients with angiosarcoma of breast. Cancer Med 2023. [PMID: 37143261 DOI: 10.1002/cam4.6042] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 04/12/2023] [Accepted: 04/23/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND Angiosarcoma of the breast is a rare malignancy. There are little data evaluating the survival and estimating the prognostic factors. The best surgical management and the role of systemic adjuvant therapy remain ill-defined. This study aimed to investigate the clinicopathological features, survival, and prognostic factors of breast angiosarcoma. METHODS The data on patients diagnosed with breast angiosarcoma were extracted from the Surveillance, Epidemiology, and End Results database (1975-2016). Univariate and multivariate Cox regression analyses were used to estimate the influential prognostic factors. The overall survival (OS) and disease-specific survival (DSS) of patients with breast angiosarcoma were evaluated. RESULTS This study included 656 patients diagnosed with breast angiosarcoma between 1975 and 2016. The 5-year OS rate of all patients was 44.9% (95% CI 40.8-49.0). In both OS and DSS, Kaplan-Meier survival analyses revealed significant differences for both OS and DSS according to age, year at diagnosis, laterality, grade, and stage (all log-rank p < 0.05). Multivariate analysis suggested that lesions of the right breast, poor differentiation, and advanced stage were independent risk factors for OS or DSS (all p < 0.05). Older age was a risk factor in OS, but was protective in DSS. In primary breast angiosarcoma, age, laterality, grade, and stage were independent prognostic factors in OS and DSS (all p < 0.05). Mastectomy was also a risk factor in DSS (p = 0.034). The proportion of patients with grade III and regional disease was larger in the mastectomy group. CONCLUSION Angiosarcoma of the breast had a poor prognosis. In our study, age, laterality, histologic grade, and stage were identified as significant prognostic factors. Why patients with angiosarcoma of the right breast had a worse prognosis remains equivocal. Mastectomy was adopted more often by surgeons in this cohort study for patients with advanced primary breast angiosarcoma.
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Affiliation(s)
- Junfeng Li
- Department of Breast and Thyroid Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yunhai Li
- Department of Breast and Thyroid Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yuanyuan Wang
- Department of Breast and Thyroid Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhao Li
- Department of Breast and Thyroid Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Huan Zhang
- Department of Breast and Thyroid Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yidan Gao
- Department of Breast and Thyroid Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jinxiang Tan
- Department of Breast and Thyroid Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Kato R, Kibudde S, Mwondha Y, Farah S. A rare case of soft tissue sarcoma in the supraclavicular region: A case report. Clin Case Rep 2023; 11:e7211. [PMID: 37143452 PMCID: PMC10151596 DOI: 10.1002/ccr3.7211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 01/18/2023] [Accepted: 04/04/2023] [Indexed: 05/06/2023] Open
Abstract
Sarcomas of the head and neck account for about 2% of all head and neck malignancies in adults. The median age at diagnosis is 50-54 years with a slight male predominance. The rarity of these sarcomas and lack of prospective trials make it difficult to reach valid conclusions. A 36-year-old woman was referred to our hospital because of an expanding non-pulsatile mass in the right supraclavicular fossa with associated numbness and paresthesia of the right forearm. The patient reported that the mass had gradually enlarged for the past 5 months. She had no history of trauma or any chronic illnesses. A physical examination revealed a mass measuring approximately 7 cm × 5 cm above the right clavicle with no palpable thrill or bruit. Ultrasound-guided biopsy was done and the histology report revealed soft tissue cells, fatty cells, and skeletal muscle cells; no tumor cells were identified. Magnetic resonance angiogram studies were made and revealed a highly vascularized supraclavicular mass. Under a multidisciplinary approach, the mass was resected. Head and neck sarcomas are relatively rare tumors and those of the head and neck account for about 2% of all head and neck malignancies and 4%-10% of all sarcomas in adults. The main histologic subtypes are rhabdomyosarcoma, osteosarcoma, chondrosarcoma, and angiosarcoma.
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Affiliation(s)
- Ronald Kato
- Department of Emergency MedicineSavannah HospitalNairobiKenya
| | - Solomon Kibudde
- Department of solid tumorsUganda Cancer InstituteKampalaUganda
| | - Yusuf Mwondha
- Department of General MedicineTendercare HospitalNairobiKenya
| | - Starlin Farah
- Department of General MedicineTendercare HospitalNairobiKenya
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Paraandavaji E, Hadidi H, Norouzi M, Azaddehghan M, Khodaparasti M, Shafiei S, Ghadirzadeh E, Nekooghadam SM, Karimi H. Paraneoplastic acute eosinophilic pneumonia due to carotid angiosarcoma: A rare case. Clin Case Rep 2023; 11:e7348. [PMID: 37220510 PMCID: PMC10199819 DOI: 10.1002/ccr3.7348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 04/24/2023] [Accepted: 05/01/2023] [Indexed: 05/25/2023] Open
Abstract
Key Clinical Message This case report emphasizes that we should analyze a patient's signs and symptoms as a whole rather than relying exclusively on a common pattern to diagnose the condition and indicates that thorough histological investigation and sample collection are needed to accurately diagnose this malignancy. Abstract Angiosarcoma is a rare, fatal, and poorly understood malignant tumor of vascular endothelial cells which is a challenging disease to diagnose in the clinical settings and requires early diagnosis to achieve a favorable prognosis. Paraneoplastic syndromes associated with angiosarcoma can include hypercoagulability, thrombocytopenia, anemia, fever, weight loss, and night sweats. In some cases, the paraneoplastic syndrome can be the first sign of the underlying malignancy. Here, we present a 47-year-old individual with angiosarcoma over the right scapula accompanied by hemoptysis and other pulmonary complaints whom at first was thought to be metastatic polmunary involvement. However, the patient's dramatic response to corticosteroids, in addition to further imaging and paraclinical studies, led us to an acute eosinophilic pneumonia (AEP) diagnosis which is an eosinophilic infiltrations of alveolar spaces. The patient received chemotherapy for angiosarcoma and radiation, since the brachial nerve network was disrupted, leaving the tumor unresectable. After 3 years of continuous follow-up, the patient is now completely cured.
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Affiliation(s)
- Elham Paraandavaji
- Skull Base Research Center, Loghman Hakim HospitalShahid Beheshti University of Medical SciencesTehranIran
- Research Assistant, Gastroenterology, and Liver Diseases Research CenterResearch Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical SciencesTehranIran
| | - Homa Hadidi
- Kermanshah University of Medical ScienceKermanshahIran
| | | | | | | | - Sasan Shafiei
- Skull Base Research Center, Loghman Hakim HospitalShahid Beheshti University of Medical SciencesTehranIran
- Research Assistant, Gastroenterology, and Liver Diseases Research CenterResearch Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical SciencesTehranIran
| | - Erfan Ghadirzadeh
- Research Assistant, Gastroenterology, and Liver Diseases Research CenterResearch Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical SciencesTehranIran
- Cardiovascular Research CenterMazandaran University of Medical SciencesSariIran
| | - Seyyed Mojtaba Nekooghadam
- Assistant Professor of Internal Medicine, Department of Internal MedicineSchool of Medicine, Shahid Beheshti University of Medical SciencesTehranIran
| | - Hanie Karimi
- School of Medicine, Tehran University of Medical SciencesTehranIran
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Lin Y, Yu H, Wang C, Zhang D. Primary pulmonary angiosarcoma mimicking diffuse pulmonary hemorrhage: A case report. Oncol Lett 2023; 25:211. [PMID: 37123023 PMCID: PMC10131260 DOI: 10.3892/ol.2023.13797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 03/09/2023] [Indexed: 05/02/2023] Open
Abstract
Pulmonary angiosarcomas are usually secondary tumors, and a primary angiosarcoma of the lung is extremely rare. The present study reports a case of an elderly patient diagnosed with primary pulmonary angiosarcoma (PPA). A 78-year-old man presented with a 3-month history of cough and blood in phlegm. A computed tomography scan of the chest indicated pulmonary infection with ground-glass opacity in the right upper lobe. The patient underwent lobectomy of the right upper lobe as his clinical symptoms did not significantly improve after anti-infection treatment. The postoperative pathological examination confirmed a diagnosis of PPA. He developed left lung and pelvic metastases 1 month after surgery. After four cycles of liposomal doxorubicin therapy, the patient achieved partial remission. The patient remained in sustained remission after 6 months of follow-up. The present case report is intended to provide diagnostic insight into PPA. In addition, the findings indicate that timely diagnosis and treatment of PPA are very important due to its increased risk of local recurrence and distant metastasis.
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Affiliation(s)
- Yong Lin
- Department of Gastroenterology, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, Hubei 441000, P.R. China
| | - Han Yu
- Department of Pathology, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, Hubei 441000, P.R. China
| | - Changying Wang
- Department of Oncology, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, Hubei 441000, P.R. China
| | - Dongdong Zhang
- Department of Oncology, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, Hubei 441000, P.R. China
- Correspondence to: Dr Dongdong Zhang, Department of Oncology, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, 15 Jiefang Road, Xiangyang, Hubei 441000, P.R. China, E-mail:
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