Angiosarcoma secondary to postirradiation and chronic lymphedema: Case reports

Medicine (Baltimore). 2021 Dec 3;100(48):e27985. doi: 10.1097/MD.0000000000027985.

Abstract

Introduction: Angiosarcoma secondary to post-irradiation and lymphedema is rare, but it is aggressive with a poor prognosis. It is essential to understand these patients' clinical features and distinguish them from benign diseases or other malignant tumors.

Patient concerns: Three patients who had radiotherapy for cancer treatment and chronic lymphedema admitted to the hospital with specific skin lesions at upper or lower extremities.

Diagnosis: Excisional biopsies revealed prominent, highly atypical cells with a vasoformative area, composed of atypical, large epithelioid cells with vesicular nuclei, prominent nucleoli, and mitoses. Immunohistochemistry revealed diffuse expression of endothelial cell markers suggestive of angiosarcoma.

Interventions: One patient had shoulder disarticulation with wide excision with adjuvant radiotherapy and chemotherapy and other 2 discontinued the treatment.

Outcomes: After the treatment, one patient was transferred to rehabilitation department for shoulder disarticulation prosthesis fitting without recurrence sign for 1 year. Two patient refused further treatment and was lost to follow-up.

Conclusion: In cases of patients with irratiation and chronic lymphedema, clinical findings suggestive of angiosarcoma, biopsy and imaging studies should be performed as soon as possible.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Biopsy
  • Cell Nucleus
  • Chronic Disease
  • Female
  • Hemangiosarcoma / etiology*
  • Hemangiosarcoma / pathology
  • Humans
  • Immunohistochemistry
  • Lymphedema / etiology*
  • Lymphedema / pathology
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Radiation Injuries*
  • Skin Neoplasms / etiology*
  • Skin Neoplasms / pathology