Angiosarcoma of the Face and Scalp

Liu, Alex C.; Kapp, Daniel S.; Egbert, Barbara M.; Waters, Linda M.; Rosen, Joseph M.

doi:10.1097/00000637-199001000-00013

Cited by 33 publications

(22 citation statements)

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“…23 They occur almost exclusively in I of 3 separate clinical presentations: ( 1) previously irradiated skin; ( 2 ) the face and scalp of elderly patients; and (3) the chronic lymphedematous extremity, often in postmastectomy patients. 24 The long-term prognosis for these patients is extremely poor, with a reported median survival time of only 20 months after radical surgxal excision and adjuvant radiotherapy. 25 The only two prognostic factors identified in humans with cutaneous HSA include the size of the lesion at the time of diagnosis and the degree of lymphocytic infiltration around the t~m o r .~~,~~ Tumors less than 5 cm in diameter and those with lymphocytic infiltrates are associated with longer survival times.…”

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confidence: 99%

Cutaneous Hemangiosarcoma in 25 Dogs: A Retrospective Study

Ward

Fox

et al. 1994

Veterinary Internal Medicne

126

120

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Hemangiosarcomas confined to the skin and underlying muscle were surgically excised in 2 5 dogs. Tumors were staged based on their histological location (ie, dermal, hypodermal, and deep). Dermal (stage I) hemangiosarcomas were small, most commonly ventral-abdominal or prepucia1 in location, and were associated with prolonged survival times (median survival, 780 days). Tumors with hypodermal (stage II) and underlying muscular involvement (stage 111) were grouped together because of their larger size, bruise-like appearance, lack of anatomic predilection, emangiosarcoma (HSA, malignant hemangioendo-H thelioma, angiosarcoma) is a neoplasm arising from endothelial cells.' It occurs more frequently in the dog than in any other species, with a reported prevalence of 0.3% to 2.0%.2-6 The spleen is the most frequent primary site of involvement; however, primary dermal and hypodermal HSAs are also common, accounting for 14% of these tumors in There are few reports specifically describing the biological behavior of HSAs originating from cutaneous (ie, dermal or hypodermal) tissues in dogs."-" Most cutaneous forms are included in the literature as part ofa large series ofdogs with HSAs, regardless of the tissue of rigi in.^,','^-^^ Frequently, it is difficult to distinguish cutaneous HSA from HSA of other origins (eg, splenic, right atrial) in these reports. The presence of 1 or more cutaneous HSAs may represent metastatic disease rather than a primary lesion, and therefore has frequently been associated with a poor prognosis." Cutaneous HSAs are rare in humans, in whom they have been described as highly invasive neoplasms with a high rate of local recurrence.23 They occur almost exclusively in I of 3 separate clinical presentations: ( 1) previously irradiated skin; ( 2 ) the face and scalp of elderly patients; and (3) the chronic lymphedematous extremity, often in postmastectomy patients.24 The long-term prognosis for these patients is extremely poor, with a reported median survival time of only 20 months after radical surgxal excision and adjuvant radiotherapy.25 The only two prognostic factors identified in humans with cutaneous HSA include the size of the lesion at the time of diagnosis and the degree of lymphocytic infiltration around the t~m o r .~~,~~ Tumors less than 5 cm in diameter and those with lymphocytic infiltrates are associated with longer survival times.",26Vascular stasis, radiation therapy, trauma, and sun exposure have been suggested as predisposing factors for the development of cutaneous HSAs in humans.26 Solar radiation has been proposed to play a causal role in spontaneously occumng dermal HSAs in dogs.'' In addition, HSAs have been experimentally induced with UV radiation in dogs2'The purpose of this study is to describe the clinical characteristics and survival times in dogs with primary cutaneous HSAs treated by surgical excision. Materials and MethodsRecords of the University of Florida and The Ohio State University veterinary pathology services were reviewed to identify all pribiological beha...

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mentioning

confidence: 99%

Cutaneous Hemangiosarcoma in 25 Dogs: A Retrospective Study

Ward

Fox

et al. 1994

Veterinary Internal Medicne

126

120

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“…With an average follow-up of four months, four of five patients were found to be disease free. However, these enviable results do not appear to represent the general experience [7,22,24,36].…”

Section: Treatmentmentioning

confidence: 87%

“…A spectrum of treatments can be found in the literature to include surgery, radiation or a combination of these. Although no modality of treatment seems superior, most authors seem to favor surgical excision as the cornerstone of treatment [1,14,22,29,34]. This contention is supported by the finding in many reports of no survivors without surgical intervention.…”

Section: Treatmentmentioning

confidence: 99%

Orbital angiosarcoma ? case report and treatment options

et al. 1997

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Abstract.Orbital angiosarcoma is an exceedingly rare subgroup of angiosarcoma. Angiosarcoma makes up less than 1% of all soft tissue sarcomas. Fifteen reported cases to date of orbital angiosarcoma demonstrate its size-dependent, aggressive, widely infiltrative nature, poor circumscription, multifocality, tendency for local recurrence, predilection for pediatric age groups, and dismal prognosis. Hufnagel and Koo [18] in 1987 eloquently and comprehensively reviewed the literature regarding this unusually rare subset of angiosarcoma. Proptosis associated with blepharoptosis was the most common presenting symptom. Further, swelling was noted in approximately one-half of the patients, and ophthalmoplegia was noted in approximately one-fourth. In addition, Hufnagel and Koo [18] reviewed the treatment options for orbital angiosarcoma. The options range from excision alone, excision followed by radiating therapy (RT), orbital exenteration, exenteration with RT and exenteration with RT and chemotherapy. They noted no apparent correlation between treatment modality and long-term outcome. Only three of the fifteen patients were noted to be alive without evidence of disease at 14 months, 1.5 years, and 2.5 years. The purpose of this paper is to document this rare case, to demonstrate the utility of en block resection with staged reconstruction and to report long-term survival.Key words: Orbit -Angiosarcoma -Reconstruction Case reportA 71-year-old male presented to the Institute for Craniofacial and Reconstructive Surgery at Providence Hospital, Southfield, Michigan in November of 1991, stating a six week history of swelling of the left side of the nose and medial canthal region. He was otherwise asymptomatic without ocular, nasal or lacrimal system-related symptoms. The patient underwent fine needle aspiration cy- En block resection of the left medial canthus, medial orbit including roof and floor, as the medial aspect of both the upper and lower eyelids was then performed. Initial reconstruction utilized a lower eyelid switch flap (Mustarde) for the first stage upper eyelid reconstruction and a forehead flap for nasal and medial canthal reconstruction. Six weeks later, second stage reconstruction was accomplished by insetting the lower eyelid switch flap into the upper eyelid defect. A nasal chondromucosal graft was then harvested, sutured into place in the lower eyelid, and a cheek flap was then raised to complete the lower eyelid reconstruction. The patient has been followed closely postoperatively, both with clinical exams and follow-up scans, and shows no evidence of recurrent nor metastatic disease at 41/2 years. DiscussionAngiosarcoma is a rare entity comprising less than 1% of all soft tissue sarcomas. The etiology of angiosarcoma has been speculatively linked to a number of elements. For example: 1) connective tissue dystrophy secondary to chronic lymphedema [27], 2) upper extremity lymphedema associated with the post-mastectomy patient [6,15,16], radiotherapy in a variety of different clinical settings [2,11,14,2...

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“…Early diagnosis is very important in order to avoid metastasis and local relapse, which are caused by tumor multifocality and the aggressive behavior of the tumor. The most common sites of metastasis are, in order, the cervical lymph nodes, lungs, and liver 12) . In our series, the major cause of death was lung metastasis.…”

Section: Discussionmentioning

confidence: 99%

Clinical Experience regarding Paclitaxel Treatment for Scalp Angiosarcomas: A Preliminary Report

Lin

Liu

et al. 2007

Ann. Cancer Res. Therap.

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Background: Scalp angiosarcoma is an aggressive tumor characterized by a rapid and fatal course. The overall prognosis of scalp angiosarcomas is poor. Recently, paclitaxel was found to be useful for scalp and facial angiosarcomas. Methods: We conducted a retrospective review of paclitaxel in the treatment of scalp angiosarcoma patients who were admitted to the Veterans General Hospital, Taipei from 1996 to 2005 (10 years). Of these patients, 4 initially received paclitaxel and radiotherapy (1 patient underwent surgery in addition to this treatment), and 6 patients underwent either surgery alone or surgery combined with radiotherapy. Disease-free interval and overall survival duration were calculated. Statistic analyses were carried out using Student's t-test. Results: The disease-free interval was significantly prolonged in patients who received paclitaxel in the initial treatment protocol (17.8 vs. 5.7 months, p = 0.016). The overall survival duration was also prolonged in these patients; however, the difference was not significant (26.5 vs. 11.1 months, p = 0.075). The prognosis was poor in the case of disease recurrence or metastases. Conclusions: Although it was difficult to completely eliminate selection bias in this retrospective review due to the limited number of cases, paclitaxel as an initial treatment regimen for primary scalp angiosarcoma after surgery or radiotherapy appeared to prolong the disease-free interval and improve patients' quality of life.

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Angiosarcoma of the Face and Scalp

Cited by 33 publications

References 0 publications

Cutaneous Hemangiosarcoma in 25 Dogs: A Retrospective Study

Cutaneous Hemangiosarcoma in 25 Dogs: A Retrospective Study

Orbital angiosarcoma ? case report and treatment options

Clinical Experience regarding Paclitaxel Treatment for Scalp Angiosarcomas: A Preliminary Report

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