Well-Differentiated Angiosarcoma of the Skin Following Radiotherapy

Epithelioid hemangioendothelioma after radiotherapy for congenital hemangioma: a case report

“…Kirova et al [13] investigated 13,472 patients with breast cancers treated with radiotherapy and reported that radiation-induced sarcomas (RIS) occurred in 27 patients, including 24 soft tissue sarcomas; 13 of the 27 RIS (48%) patients had angiosarcomas. Although angiosarcoma induced by radiotherapy for hemangioma has been documented in nine cases [2][3][4][5][6][7][8][9][10] (Table 1), there have been no reports of irradiation-induced epithelioid hemangioendothelioma. Nevertheless, it is clear that epithelioid hemangioendothelioma has a close relationship with angiosarcoma.…”

“…Apart from the direct carcinogenic effect of irradiation, prolonged stimulation due to tissue repair occurring as a result of tissue damage secondary to irradiation-induced vascular changes also plays an etiologic role in the development of angiosarcomas [15]. Angiosarcomas arising in the irradiation site of a congenital hemangioma have two characteristic properties [2][3][4][5][6][7][8][9][10]. First, most patients underwent radiotherapy in childhood.…”

“…In 1950, McCarthy and Pack [1] first reported the development of angiosarcoma following prior radiotherapy for hemangioma. Several studies suggest a definite cause-and-effect relationship to exist between irradiation and angiosarcoma [2][3][4][5][6][7][8][9][10]. Apart from the direct carcinogenic effect of irradiation, the prolonged stimulation of tissue repair resulting from tissue damage secondary to irradiation-induced vascular changes, which also play an etiologic role in the development of angiosarcomas.…”

Bilateral angiosarcoma of the breast in a fourteen-year-old child

“…14 In children AS has been described following radiotherapy for vascular disorders at a very young age. 15 Other documented risk factors include: xeroderma pigmentosum, 16 neurofibromatosis I, 7 and exposure to vinyl chloride. 17 The diagnosis of AS in the breast may be suspected on clinical examination when red-blue discoloration of the skin is present; in later stages nodular tumor growth appears.…”

Malignant vascular tumors in young patients

“…21 Furthermore, there are at least 36 cases of malignant transformation of a benign hemangioma after radiotherapy. [22][23][24][25] The median age at which patients received radiation therapy was 2.8 years (range, 2 months-15 years) and the median dose of radiation was 35 gray (Gy) (range, 8 -71 Gy). The reported median latent period from irradiation to the diagnosis of angiosarcoma was 21.8 years (range, 14 -33 years).…”