Angiosarcoma of the lungs, liver, and bones in a 27-year-old male patient
Abstract
Angiosarcoma is a rare (from 1% to 2% of all soft tissue sarcomas), highly aggressive endothelial tumor that may affect any organ. The prognosis for the disease is poor, particularly if it is metastatic by the time of diagnosis. The etiology is unclear; however, there are definite risk factors including chronic lymphedema, radiation therapy, familial syndromes, and exposure to environmental chemical toxins and foreign bodies. Although the final diagnosis is histopathological, radiological tools such as ultrasound, CT, and MRI are still necessary to determine the stage of cancer. Treatment includes surgery, chemotherapy, and radiation therapy. Chemotherapy is the main treatment strategy for metastatic angiosarcoma, however, the toxicity level of frequently used agents is high. The research focuses on targeted medicines and immunotherapy as potential therapeutic options. We present a case of angiosarcoma in a young man without chronic illnesses with metastatic spread to the lungs, liver, and bones at the time of diagnosis
Keywords: angiosarcomametastasesetiologydiagnostic toolstreatmentprognosis
References
- Young RJ, Woll PJ, Staton CA, et al. Angiosarcoma. Lancet Oncol. 2010; 11(10): 983–991.
- Shon W, Billings SD. Cutaneous malignant vascular neoplasms. Clin Lab Med. 2017; 37(3): 633–646.
- Buehler D, Rice SR, Moody JS, et al. Angiosarcoma outcomes and prognostic factors: a 25-year single institution experience. Am J Clin Oncol. 2014; 37(5): 473–479.
- Tateishi U, Hasegawa T, Kusumoto M, et al. Metastatic angiosarcoma of the lung: spectrum of CT findings. AJR Am J Roentgenol. 2003; 180(6): 1671–1674.
- Tateishi U, Hasegawa T, Muramatsu Y, et al. Hepatic metastases of soft tissue angiosarcoma: CT and MR imaging findings. Abdom Imaging. 2003; 28(5): 660–664.
- Colas M, Gérazime A, Popescu D, et al. Angiosarcoma: A population-based cancer registry descriptive study of 45 consecutive cases diagnosed between 1979 and 2016. Rare Tumors. 2020; 12: 2036361320979216.
- Gaballah AH, Jensen CT, Palmquist S, et al. Angiosarcoma: clinical and imaging features from head to toe. Br J Radiol. 2017; 90(1075): 20170039.
- Rouhani P, Fletcher CDM, Devesa SS, et al. Cutaneous soft tissue sarcoma incidence patterns in the U.S. : an analysis of 12,114 cases. Cancer. 2008; 113(3): 616–627.
- Mesli S, Ghouali A, Benamara F, et al. Stewart-Treves syndrome involving chronic lymphedema after mastectomy of breast cancer. Case Reports in Surgery. 2017; 2017: 1–4.
- Virtanen A, Pukkala E, Auvinen A. Angiosarcoma after radiotherapy: a cohort study of 332,163 Finnish cancer patients. Br J Cancer. 2007; 97(1): 115–117.
- Huang NC, Wann SR, Chang HT, et al. Arsenic, vinyl chloride, viral hepatitis, and hepatic angiosarcoma: a hospital-based study and review of literature in Taiwan. BMC Gastroenterol. 2011; 11: 142.
- Terrando S, Sambri A, Bianchi G, et al. Angiosarcoma around total hip arthroplasty: case series and review of the literature. Musculoskelet Surg. 2018; 102(1): 21–27.
- Banza MI, Tshiamala IB, Mukakala AK, et al. [Angiosarcoma of the shoulder revealed by previous trauma: about a case and literature review]. Pan Afr Med J. 2020; 36: 40.
- Bhaludin BN, Thway K, Adejolu M, et al. Imaging features of primary sites and metastatic patterns of angiosarcoma. Insights Imaging. 2021; 12(1): 189.
- Lahat G, Dhuka AR, Hallevi H, et al. Angiosarcoma: clinical and molecular insights. Ann Surg. 2010; 251(6): 1098–1106.
- Loudon JA, Billy ML, DeYoung BR, et al. Angiosarcoma of the mandible: a case report and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000; 89(4): 471–476.
- Jobke B, Werner M, Jundt G, et al. Protracted disseminated skeletal metastases from angiosarcoma of the spleen. Clin Exp Metastasis. 2010; 27(2): 117–122.
- Marušić Z, Billings SD. Histopathology of spindle cell vascular tumors. Surg Pathol Clin. 2017; 10(2): 345–366.
- Ducimetière F, Lurkin A, Ranchère-Vince D, et al. Incidence of sarcoma histotypes and molecular subtypes in a prospective epidemiological study with central pathology review and molecular testing. PLoS One. 2011; 6(8): e20294.
- Hoang NT, Acevedo LA, Mann MJ, et al. A review of soft-tissue sarcomas: translation of biological advances into treatment measures. Cancer Manag Res. 2018; 10: 1089–1114.
- D'Angelo SP, Munhoz RR, Kuk D, et al. Outcomes of systemic therapy for patients with metastatic angiosarcoma. Oncology. 2015; 89(4): 205–214.
- Penel N, Lansiaux A, Adenis A. Angiosarcomas and taxanes. Curr Treat Options Oncol. 2007; 8(6): 428–434.
- Goodsell DS. Vascular endothelial growth factor (VEGF) and angiogenesis. RCSB Protein Data Bank. 2022.
- Wagner MJ, Othus M, Patel SP, et al. Multicenter phase II trial (SWOG S1609, cohort 51) of ipilimumab and nivolumab in metastatic or unresectable angiosarcoma: a substudy of dual anti-CTLA-4 and anti-PD-1 blockade in rare tumors (DART). J Immunother Cancer. 2021; 9(8).
- Hata M, Hata M, Wada H, et al. Radiation therapy for angiosarcoma of the scalp: total scalp irradiation and local irradiation . Anticancer Res. 2018; 38(3): 1247–1253.
- Wang L, Lao IW, Yu L, et al. Clinicopathological features and prognostic factors in angiosarcoma: a retrospective analysis of 200 patients from a single chinese medical institute. Oncol Lett. 2017; 14(5): 5370–5378.