Radiation-Associated Angiosarcoma as a Presentation of Disease Progression in a Patient on Immunotherapy for Metastatic Non-small Cell Lung Cancer

Hannah Tan; Beatrice E Torere; Sherry Okun; Benjamin Hinton

doi:10.7759/cureus.44724

Radiation-Associated Angiosarcoma as a Presentation of Disease Progression in a Patient on Immunotherapy for Metastatic Non-small Cell Lung Cancer

Cureus. 2023 Sep 5;15(9):e44724. doi: 10.7759/cureus.44724. eCollection 2023 Sep.

Authors

Hannah Tan¹, Beatrice E Torere², Sherry Okun³, Benjamin Hinton⁴

Affiliations

¹ Hematology and Oncology, East Tennessee State University, Johnson City, USA.
² Internal Medicine, North Mississippi Medical Center, Tupelo, USA.
³ Pathology, North Mississippi Medical Center, Tupelo, USA.
⁴ Radiation Oncology, North Mississippi Medical Center, Tupelo, USA.

Abstract

Non-small cell lung cancer (NSCLC) is the dominant form of lung cancer, comprising around 85% of cases. Stage 4 NSCLC has a grim prognosis; however, immunotherapy and radiation therapy have become vital treatments for advanced-stage NSCLC, despite the risk of inducing a second primary malignancy. This case report focuses on a 45-year-old female diagnosed with NSCLC and metastasis to the 11th thoracic vertebral body. After various treatments, including radiation, a potential radiation-associated secondary malignancy, epithelial angiosarcoma, was discovered. Following treatment modification, the patient achieved complete metabolic remission, highlighting the importance of clinicians being cautious about secondary primary cancers in NSCLC patients with a history of radiation therapy. Accurate diagnosis through biopsy and continuous surveillance are essential in managing NSCLC patients effectively.

Keywords: adenocarcinoma of the lung; epithelioid angiosarcoma; metastatic non-small cell lung cancer; nccn guidelines; non-small cell lung carcinoma (nsclc); radiation-associated cancer; secondary primary cancer; stage iv nsclc.

Publication types

Case Reports