301
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Givens SS, Ellerbroek NA, Butler JJ, Libshitz HI, Hortobagyi GN, McNeese MD. Angiosarcoma arising in an irradiated breast. A case report and review of the literature. Cancer 1989; 64:2214-6. [PMID: 2680051 DOI: 10.1002/1097-0142(19891201)64:11<2214::aid-cncr2820641105>3.0.co;2-e] [Citation(s) in RCA: 54] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The authors discuss an angiosarcoma that developed in a 50-year-old woman's breast 10 years after she underwent conventional postoperative irradiation with cobalt 60 teletherapy. Although angiosarcoma developing in a lymphedematous arm after radical mastectomy is a well-known phenomenon, and several cases of angiosarcoma are known to have occurred in the chest wall after mastectomy with or without irradiation, only one other case of angiosarcoma in an irradiated breast has been reported. The possible role of therapeutic irradiation in inducing this malignancy is discussed.
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Affiliation(s)
- S S Givens
- Department of Clinical Radiotherapy, University of Texas M.D. Anderson Cancer Center, Houston 77030
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302
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Abstract
Soft tissue sarcomas in infants and children differ from those in adults in clinical presentation, histology, and response to therapy. For rhabdomyosarcoma, the most common sarcoma in children, each primary site has special characteristics that affect both treatment programs and survival rates. Some results are so good, from the standpoint of survival data, that studies are now in progress to evaluate means of reducing treatment morbidity. Other ongoing studies focus on improved protocols for metastatic or recurrent rhabdomyosarcoma. Results thus far in the IRS trials have proven the value of cooperative clinical trials in the management of patients with this disease.
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Affiliation(s)
- W Lawrence
- Division of Surgical Oncology, Medical College of Virginia, Virginia Commonwealth University, Richmond
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303
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Sánchez RB, Quinn SF, Walling A, Estrada J, White V. Case report 569: Lymphangiosarcoma of the right upper extremity. Skeletal Radiol 1989; 18:485-7. [PMID: 2814561 DOI: 10.1007/bf00368623] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- R B Sánchez
- Department of Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33682-0179
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304
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Silverman JF, Lannin DL, Larkin EW, Feldman P, Frable WJ. Fine-needle aspiration cytology of postirradiation sarcomas, including angiosarcoma, with immunocytochemical confirmation. Diagn Cytopathol 1989; 5:275-81. [PMID: 2477205 DOI: 10.1002/dc.2840050309] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Postirradiation sarcomas are an unusual but well-recognized late effect of cancer therapy. In this article, a fine-needle aspiration (FNA) series of four cases is presented. There were three female patients and one male patient, with an age range of 28-55 yr (mean, 41). Two of the patients were irradiated for uterine cervical carcinoma while the other two received irradiation for malignant lymphoma. The time interval to the development of the postirradiation sarcoma ranged from 10 to greater than 20 yr. There were a postirradiation synovial sarcoma of the buttock region, malignant fibrous histiocytoma of the bone (femur), and rhabdomyosarcoma and angiosarcoma of the retroperitoneum. A spectrum of cytologic findings was encountered, reflecting the specific types of sarcomas. Immunocytochemical studies performed on the aspirated material from the angiosarcoma demonstrated the utility of immunoperoxidase stains for ULEX europaeus agglutinin-1 (UEA-1) and, to a lesser degree, factor VIII-related antigen antibody, confirming the vascular nature of this malignancy. The FNA findings from all four cases demonstrated cytologic features that allowed recognition of this unusual complication of irradiation treatment. This article confirms the utility of FNA cytology in following patients with previous malignancies and differentiating a postirradiation sarcoma from recurrent carcinoma.
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Affiliation(s)
- J F Silverman
- Department of Clinical Pathology, East Carolina University School of Medicine, Greenville, NC
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305
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306
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Evans HL, Chawla SP, Simpson C, Finn KP. Smooth muscle neoplasms of the uterus other than ordinary leiomyoma. A study of 46 cases, with emphasis on diagnostic criteria and prognostic factors. Cancer 1988; 62:2239-47. [PMID: 3179938 DOI: 10.1002/1097-0142(19881115)62:10<2239::aid-cncr2820621028>3.0.co;2-y] [Citation(s) in RCA: 130] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Thirty-seven cases of uterine leiomyosarcoma are presented, along with nine cases of leiomyoma variants from which they were distinguished. All patients were followed for a minimum of 10 years. In cases with nuclear pleomorphism, leiomyosarcoma was diagnosed when there were five or more mitotic figures in ten consecutive high-power (X400) fields in the most active area of the tumor, and also when there were fewer mitotic figures but extensive tumor necrosis (there was only one leiomyosarcoma without nuclear pleomorphism, and it had more than 20 mitotic figures in ten high-power fields). Tumor size was the major prognostic factor in the leiomyosarcoma group; five of eight patients with neoplasms measuring less than 5 cm in maximum dimension survived, whereas no patient with a larger tumor did so. Other pathologic and clinical variables, including mitotic rate, tumor necrosis, degree of nuclear pleomorphism, vascular invasion, and patient age, had no significant relationship to survival or tumor behavior in leiomyosarcoma when tumor size was taken into account. The nine cases of leiomyoma variants consisted of three atypical leiomyomas (which had nuclear pleomorphism, one or no mitotic figures per ten high-power fields, and no necrosis), two plexiform leiomyomas, two cases of peritoneal leiomyomatosis, one palisaded leiomyoma, and one case of intravenous leiomyomatosis; all of these patients were tumor-free on follow-up.
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Affiliation(s)
- H L Evans
- Department of Pathology, University of Texas M.D. Anderson Hospital and Tumor Institute, Houston 77030
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307
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Abstract
Three cases of angiosarcoma in the stomach, small bowel, and colon, respectively, are reported. The gastric lesion occurred many years after historic evidence of cutaneous Kaposi's sarcoma. Two of the three lesions exhibited multifocality, and all demonstrated aggressive biologic courses. The varied histologic features of angiosarcoma make this diagnosis difficult to establish in an unusual location such as the gastrointestinal tract. The use of immunohistochemistry for a panel of antibodies, particularly the successful reaction with Factor VIII-related antigen, is important in evaluating light microscopically unusual tumors. A delicate framework of collagen type IV was elicited in each case, but ultrastructurally correlated with short segments of basal lamina in one case. This suggests that the absence of the traditional morphologic expression of basal lamina does not preclude its presence and emphasizes the sensitivity of immunohistochemistry. The lack of previously reported cases of gastrointestinal angiosarcoma may be because the tumor is underrecognized or because it is truly a rare occurrence.
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Affiliation(s)
- J B Taxy
- Division of Pathology, Lutheran General Hospital, Park Ridge, Illinois 60068
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308
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Becquemin JP, Lebbe C, Saada F, Avril MF. Sarcoma of the aorta: report of a case and review of the literature. Ann Vasc Surg 1988; 2:225-30. [PMID: 3056483 DOI: 10.1016/s0890-5096(07)60005-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Tumors of the aorta are extremely rare and usually malignant. We report the case of a sarcoma of the infrarenal aorta in a 67-year-old man. Initial symptoms were metastatic cutaneous nodules and lower extremity claudication. Aortography and computerized tomography of the abdomen revealed a fungating mass obstructing the aortic bifurcation. Treatment consisted of resection of the aorta, aortobiiliac bypass, and combined radiation and chemotherapy. Death occurred six months after treatment. Twenty-seven cases of angiosarcoma reported in the literature are reviewed.
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Affiliation(s)
- J P Becquemin
- Service de Chirurgie Vasculaire, Hôpital Henri Mondor, Créteil, France
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309
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Affiliation(s)
- W G Frick
- Department of Oral and Maxillofacial Surgery, Scott and White Memorial Hospital, Temple, TX 76508
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310
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Whyte RI, Joseph MP, Bennett W, Goodman ML, Brewster DC. Angiosarcoma of the carotid artery: a case report. HEAD & NECK SURGERY 1988; 10:264-8. [PMID: 3069813 DOI: 10.1002/j.1930-2398.1988.tb00010.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Angiosarcomas are rare tumors, particularly in the head and neck region. A case report of an angiosarcoma arising in the internal carotid artery is described; such an occurrence has not previously been reported. The etiology, pathology, and treatment of this unusual tumor are discussed.
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Affiliation(s)
- R I Whyte
- Department of Surgery, Massachusetts General Hospital, Boston
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311
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Levy I, Danziger Y, Mechlis-Frish S, Lubin E, Mimouni M. Technetium-labeled red blood cell imaging to evaluate soft tissue hemangioma of the hand. Pediatr Dermatol 1988; 5:47-9. [PMID: 2837746 DOI: 10.1111/j.1525-1470.1988.tb00883.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Red blood cells labeled with technetium Tc 99m were used to evaluate the vascular nature of a subcutaneous tumor in a 12-year-old girl. The low perfusion and high blood pool that characterized the lesion were considered highly suggestive of subcutaneous cavernous hemangioma. This noninvasive method for diagnosing soft tissue hemangiomas is more specific than other imaging modalities such as ultrasound and arteriography. The usefulness and the importance of the method prior to surgical biopsy or resection are discussed.
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Affiliation(s)
- I Levy
- Department of Pediatrics, Beilinson Medical Center, Petah Tikva, Israel
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312
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Daugaard S, Hultberg BM, Hou-Jensen K, Mouridsen HT. Clinical features of malignant haemangiopericytomas and haemangioendotheliosarcomas. Acta Oncol 1988; 27:209-13. [PMID: 3415848 DOI: 10.3109/02841868809093527] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The clinical features of 23 patients with malignant vascular tumours, referred for treatment in the period 1968-85, are described. The tumours consisted of 15 haemangioendotheliosarcomas (angiosarcomas) and 8 malignant haemangiopericytomas. Ten haemangioendotheliosarcomas were located in skin or mucous membranes and 5 in viscera and deep soft tissues. None of the 8 haemangiopericytomas were superficially located. One cutaneous haemangioendotheliosarcoma arose in a lymphoedematous leg, while 4 others occurred in previously irradiated areas. There was one case of a Thorotrast-induced hepatic haemangioendotheliosarcoma. No predisposing factors could be demonstrated in the cases of malignant haemangiopericytoma. Median survival was 11 months for the haemangioendotheliosarcomas and 19 months for the haemangiopericytomas. Patients who were operable at the time of admission had a longer median survival (37 months) than those who presented with advanced disease (5 months). Local control was obtained by surgery in 3 cases and by radiation therapy in 2. No complete responses were seen on chemotherapeutic regimens.
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Affiliation(s)
- S Daugaard
- Department of Oncology A, Finsen Institute, Rigshospitalet, Copenhagen, Denmark
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313
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Abstract
Records of 323 patients with TNM Stage M0 sarcoma of soft tissue treated by the Radiation Medicine Service of the Massachusetts General Hospital over a 14-year period were reviewed to study the incidence and the implication of regional lymph node involvement. Nineteen patients (5.9%) had evidence of sarcoma metastatic to draining lymph nodes, zero of 63 (0%) were Grade 1 sarcomas, two of 118 (2%) were Grade 2, and 17 of 142 (12%) were Grade 3 sarcomas. Among patients with Grade 3 sarcomas, rhabdomyosarcoma (five of 14), vascular sarcoma (two of five), and epithelioid sarcoma (four of five) were associated with a higher incidence of lymph node involvement than synovial sarcomas (zero of four), fibrosarcomas (zero of 16), malignant fibrohistiocytomas (one of 29), neurofibrosarcomas (one of eight), liposarcomas (one of 14), and leiomyosarcomas (one of ten). From the 19 patients who had evidence of metastatic nodes, six (32%) were alive more than 58 months after the treatment of the nodes; four of six patients were without further tumor. The data of this study are compared with those cited in a review of the literature.
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Affiliation(s)
- J J Mazeron
- Radiation Medicine Service, Massachusetts General Hospital, Boston
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314
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Abstract
A 47-year-old woman presented with an angiosarcoma of the terminal ileum 14 years after receiving adjuvant radiation therapy for ovarian dysgerminoma. Her clinical course is described, and the previously reported cases of radiation-induced angiosarcoma are reviewed.
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315
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Proceedings of the 237th meeting of the Netherlands Society for Dermatology and Venereology. Utrecht, 31 May 1986. Abstracts. Br J Dermatol 1987; 116:591-603. [PMID: 3580293 DOI: 10.1111/j.1365-2133.1987.tb05885.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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316
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Abstract
72 patients with angiosarcoma (AS) of the face and scalp have been analyzed with respect of various prognostic factors and the effects of different treatment regimes. This disease predominantly occurs in the elderly (age range, 56-92 years), and affects men rather more frequently than women (men: 44, women: 28). The clinical presentation varied, and included bruise-like lesions, dusky plaques, chronic edema or cellulitis, ulcerated nodules, pyoderma, and infected conditions. Due to lack of clinical awareness and problems with histologic assessment, delays in diagnosis were frequent. The majority of the tumors arose in the upper part of the face or scalp. Less commonly, the central part of the face was affected while only three tumors developed in the mandibular region. Overall the prognosis was poor; one half of the patients died within 15 months of presentation. Only 12% of the patients survived 5 years or more. Patients with lesions that were less than 10 cm in diameter responded better to treatment and statistically survived longer than those with larger lesions, emphasizing the crucial importance of early diagnosis. There is some indication that men, younger patients, patients with lesions on the central part of the face survived longer, but this was not of statistical significance. The histologic differentiation of the tumors at presentation also was of doubtful prognostic significance. Despite the overall poor prognosis, radical radiotherapy (mostly wide-field electron-beam therapy) in seven patients resulted in the apparent eradication of the local skin disease and prolonged survival of the patients. Pulmonary metastases developed 10 years later in two of those patients, however, but the face and scalp remained tumor-free.
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317
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Holden CA, Spaull J, Das AK, McKee PH, Jones EW. The histogenesis of angiosarcoma of the face and scalp: an immunohistochemical and ultrastructural study. Histopathology 1987; 11:37-51. [PMID: 3104187 DOI: 10.1111/j.1365-2559.1987.tb02607.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Thirteen cases of angiosarcoma of the face and scalp have been examined using immunohistochemistry and electron microscopy. Endothelial cell markers have been employed in an immunoperoxidase technique on tissue that has either been routinely processed, periodate-lysine paraformaldehyde fixed (PLP) and cold processed, or fixed in methacarn. A consistent pattern of endothelial cell labeling was only achieved in the PLP fixed tissue. In this fixative the angiosarcomas were factor VIII related antigen negative, Ulex europaeus lectin positive, laminin positive, unlabelled by the monoclonal antibody PAL-E, and positively labelled by the monoclonal antibody EN4. Ultrastructural examination of four cases showed evidence of vascular lumina in all tumours. Weibel-Palade bodies were seen in only one case but three tumours showed some evidence of tight junction formation and marginal folding. Thus, our cell marker studies can be interpreted as consistent with a lymphatic derivation for this type of angiosarcoma but in contra-distinction the ultrastructural studies showed tumour channels with features suggestive of blood vessel differentiation.
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318
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Hufnagel T, Ma L, Kuo TT. Orbital angiosarcoma with subconjunctival presentation. Report of a case and literature review. Ophthalmology 1987; 94:72-7. [PMID: 3550568 DOI: 10.1016/s0161-6420(87)33507-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
An otherwise healthy 37-year-old woman had, over the course of 2 years, a recurring subconjunctival lesion associated with blepharoptosis. Computed tomography (CT) demonstrated a large anterior and superior orbital mass. A diagnosis of angiosarcoma (AS) was made from biopsy material. The patient is alive and well 18 months after exenteration and radiation therapy. The clinical and histopathologic features of this tumor are discussed with emphasis on the differential diagnosis of malignant vascular tumors of the orbit.
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319
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Kitagawa M, Tanaka I, Takemura T, Matsubara O, Kasuga T. Angiosarcoma of the scalp: report of two cases with fatal pulmonary complications and a review of Japanese autopsy registry data. VIRCHOWS ARCHIV. A, PATHOLOGICAL ANATOMY AND HISTOPATHOLOGY 1987; 412:83-7. [PMID: 3120405 DOI: 10.1007/bf00750735] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Two cases of angiosarcoma of the scalp were reported. The patients were elderly men and died from pulmonary complications, including pneumothorax, pulmonary haemorrhage and pneumonia, associated with metastatic tumours in the lungs. The data recorded from 95 autopsies of patients with angiosarcoma in Japan during 1980-1984 were analyzed. According to the anatomical distribution of the primary tumour, the patients could be subdivided into a scalp group and non-scalp group. In both groups, the most common metastatic site was the lung. The patients of the scalp group had more frequent pulmonary complications such as pneumonia, haemothorax, atelectasis and pneumothorax, when compared with the patients of the non-scalp group. In particular, pneumothorax was observed only in the patients of angiosarcoma of the scalp. The results indicate that angiosarcoma of the scalp tends to metastasize to the lung, especially to the subpleural or surface pleural area and these metastatic tumours are prone to necrosis, causing characteristic pulmonary complications.
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Affiliation(s)
- M Kitagawa
- Second Department of Pathology, Faculty of Medicine, Tokyo Medical and Dental University, Japan
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320
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Slater JD, McNeese MD, Peters LJ. Radiation therapy for unresectable soft tissue sarcomas. Int J Radiat Oncol Biol Phys 1986; 12:1729-34. [PMID: 3759524 DOI: 10.1016/0360-3016(86)90312-3] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Between 1954 and 1981, 72 patients with unresectable soft tissue sarcomas were treated with radiotherapy at The University of Texas M. D. Anderson Hospital and Tumor Institute at Houston, 57 with photons alone and 15 with neutrons for at least part of the treatment. Twenty-three patients received systemic chemotherapy in addition to radiation therapy. The absolute 2-year and actuarial 5-year tumor control rates were 39 and 29%, respectively. In this heterogeneous series, the malignancy group (based on pathologic diagnosis) was the only factor significantly affecting tumor control probability, which at 5 years was 58% for 12 patients with group I tumors, 32% for 10 patients with group II tumors, and 17% for 50 patients with group III tumors. No relationship between total dose and tumor control probability was found in this group of patients, though the duration of tumor control was longer in those receiving 65 Gy or more. No apparent improvement in tumor control was observed in the subsets of patients receiving fast neutron therapy or combined modality treatment with chemotherapy, but because of the many unmatched variables between the groups, no meaningful comparison of treatment modalities can be made. Distant metastasis were seen more frequently in higher malignancy groups, whereas size or site of tumors did not significantly influence the incidence of distant metastasis. Six patients sustained major complications of radiotherapy, of whom five received total doses in excess of 70 Gy or its estimated biologic equivalent.
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321
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Abstract
A case of epithelioid hemangioendothelioma of the penis in a sixty-year-old patient is reported. This is a rare vascular tumor of borderline malignant potential. Local excision of this tumor with a cuff of normal tissue and careful follow-up of the patient is the accepted procedure.
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322
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Krause KI, Hebert AA, Sanchez RL, Solomon AR. Anterior abdominal wall angiosarcoma in a morbidly obese woman. J Am Acad Dermatol 1986; 15:327-30. [PMID: 2942581 DOI: 10.1016/s0190-9622(86)70170-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
A review of the literature showed that angiosarcomas of the anterior abdominal wall are rare neoplasms and that all published cases have been preceded by irradiation and/or prior surgery. We believe that our case of a primary angiosarcoma of the anterior abdominal wall is unique and that chronic lymphedema secondary to morbid obesity may be of etiologic importance.
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323
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Abstract
A case of angiosarcoma (malignant hemangioendothelioma) developing in a chronic goitrous thyroid gland of an elderly Chinese woman is described. Histologically it showed the same classical appearance of angiosarcoma occurring in the skin and soft tissue. The endothelial origin of this tumor was confirmed by demonstrating Factor VIII-related antigen in the neoplastic cells with the immunoperoxidase technique and Weibel-Palade bodies by electron microscopic study. Because of its extreme rarity outside the European Alpine regions, many authorities are reluctant to accept it as a distinct entity and merely consider it as a variant of an undifferentiated carcinoma. Our report not only provides additional evidence that angiosarcoma of the thyroid gland is a specific condition of endothelial origin but also documents the first case among Chinese.
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324
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Abstract
Malignant neoplasms known to develop following external beam radiation include squamous cell carcinoma, osteosarcoma, chondrosarcoma, malignant fibrous histiocytoma, mixed mullerian tumors, malignant schwannoma, myelogenous leukemia and angiosarcoma. Latency periods of many years characterize the onset of these tumors following the exposure. Cutaneous angiosarcoma following radiotherapy for breast carcinoma has been rarely documented, occurring up to 13 years postirradiation. Two cases of this entity are reported occurring 37 months postradiotherapy at the site of mastectomy performed for mammary duct carcinoma.
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325
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Abstract
Forty-five cases of cardiac angiosarcomas were reviewed, and the data were compared with those of a 1968 review of 41 other cases which revealed these tumors to be typically located within the right atrium as large symptomatic masses and to be rapidly fatal, with the diagnoses usually determined only at autopsy. The relationship of these tumors to Kaposi's sarcoma was also examined. The findings paralleled those of the previous review. Additionally, the following points emerged: With the aid of newer imaging techniques, localization, biopsy diagnosis and resection of the atrial tumors are now being achieved more often, with some improvement in survival. Like angiosarcomas of other organs, atrial angiosarcomas exhibit highly variable histologic patterns, which often overlap those of Kaposi's sarcoma, and may also present metastatic patterns simulating widespread Kaposi's sarcoma or malignant melanoma. In reported cases of classical, endemic, or epidemic Kaposi's sarcoma, cardiac lesions are uncommon and typically are small, asymptomatic, restricted to the epicardium/or pericardium and, thus, are clearly different, both clinically and pathologically, from the atrial tumor group. The justification for designating cases of the latter group as "primary cardiac Kaposi's sarcoma" is open to debate. A case report illustrates many of the above points.
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326
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Sarashi C, Nishioka K, Maeda M, Fujikawa M, Matsumoto K, Sano S. Malignant hemangioendothelioma in discoid lupus erythematosus. J Dermatol 1986; 13:45-8. [PMID: 3522693 DOI: 10.1111/j.1346-8138.1986.tb02898.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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327
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Abstract
Two cases of angiosarcoma of the breast are presented. They are of particular interest in that one patient is a long-term survivor, the 19th reported to date, and the other presented with contralateral breast involvement without evidence of disseminated disease. The world literature is reviewed and a discussion is presented of the clinical features, treatment, histopathologic features, and prognosis of this rare breast neoplasm. Tumor size and degree of tumor differentiation are the most important prognostic indicators, and in general a simple mastectomy is the treatment of choice. The value of adjuvant irradiation and chemotherapy is uncertain.
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328
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Fletcher CD, McKee PH. Sarcomas--a clinicopathological guide with particular reference to cutaneous manifestation. III. Angiosarcoma, malignant haemangiopericytoma, fibrosarcoma and synovial sarcoma. Clin Exp Dermatol 1985; 10:332-49. [PMID: 2994920 DOI: 10.1111/j.1365-2230.1985.tb00580.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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329
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Abstract
A 61-year-old woman developed a cutaneous angiosarcoma of the lower abdomen in the site where she had received radiotherapy for squamous cell carcinoma of the cervix uteri 23 years earlier. The rarity of this event and the dermatologist's general unfamiliarity with this late complication of radiation therapy have prompted a review of cutaneous postirradiation angiosarcoma.
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330
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Olsen TG, Helwig EB. Angiolymphoid hyperplasia with eosinophilia. A clinicopathologic study of 116 patients. J Am Acad Dermatol 1985; 12:781-96. [PMID: 4008683 DOI: 10.1016/s0190-9622(85)70098-9] [Citation(s) in RCA: 314] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The clinicopathologic spectrum of angiolymphoid hyperplasia with eosinophilia (ALHE) is reported through a study of 116 cases (67 male and 49 female) submitted to the Armed Forces Institute of Pathology. The lesions are most common in the head-neck region and are characterized by single or multiple smooth-top papules or plaques of varying color. Microscopically, ALHE consists of anomalous vascular proliferations and varying degrees of nodular and diffuse lymphocytic infiltrates with eosinophils at all levels of the corium and subcutaneous tissue. In fifty-three cases an arterial structure, confirmed by the presence of an internal elastic lamina, was observed in close association with venular structures or was the site of endothelial cell proliferation. ALHE comprises a spectrum of unusual vascular proliferation with inflammation, encompassing such entities as inflammatory angiomatous nodules, pseudo or atypical pyogenic granuloma, histiocytoid hemangioma, epithelioid hemangioma, and Kimura's disease. The existence of arterial structures among venules and endothelial cell proliferations suggests the presence of arteriovenous (AV) shunts, which may help explain the pathogenesis and biologic behavior of this condition.
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331
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Abstract
In two patients with malignant germ cell tumors angiosarcoma developed through two apparently different mechanisms. In one case the angiosarcoma probably developed as a complication of therapeutic radiation, since radiation changes were demonstrated in tissue adjacent to the neoplasm and since the angiosarcoma was not associated with elements of germ cell tumor. The absence of associated germ cell elements does not support the development of the angiosarcoma from a teratoma. In the second case, however, it is likely that the angiosarcoma developed as a result of malignant change within teratomatous foci, since angiosarcomatous elements were intermingled with teratomatous elements and the patient's primary germ cell tumor contained malignant and atypical teratomatous elements as well as prominent vascular proliferation. Malignant change within teratomatous components of germ cell tumors is a phenomenon of increasing importance in this era of effective chemotherapy for germ cell tumors. The development of angiosarcoma as a potential complication of testicular carcinoma has not been reported previously.
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332
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Capo V, Ozzello L, Fenoglio CM, Lombardi L, Rilke F. Angiosarcomas arising in edematous extremities: immunostaining for factor VIII-related antigen and ultrastructural features. Hum Pathol 1985; 16:144-50. [PMID: 3918926 DOI: 10.1016/s0046-8177(85)80063-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Immunostaining for Factor VIII-related antigen was seen in deparaffinized sections from 19 of 20 postmastectomy angiosarcomas and from four of four sarcomas that arose in chronically edematous tissue unrelated to breast carcinoma. Staining was also seen in sections from two malignant hemangioendotheliomas, four capillary hemangiomas, and one granulation tissue specimen. Sections from two lymphangiomas were immunonegative for Factor VIII-related antigen in the endothelium of lymphatic channels, whereas staining was observed in the surrounding normal blood vessels. Electron microscopic study of four postmastectomy angiosarcomas disclosed ultrastructural features (fenestrae, intense pinocytotic activity, cell junctions, and Weibel-Palade bodies) supporting the blood vascular endothelial nature of the neoplastic cells. It is concluded that a neoplastic blood vessel component is present in sarcomas that arise in chronically edematous tissues. It is questionable whether a lymphatic component is also present. These tumors, therefore, should be regarded as angiosarcomas rather than lymphangiosarcomas.
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Abstract
Angiosarcoma of the larynx is an uncommon malignant tumor of mesenchymal origin. A case of angiosarcoma of the epiglottis was followed for about 6 years. Diagnostic and clinicopathologic findings outline the importance of a correct differential diagnosis from other vascular malignant tumors (malignant hemangiopericytoma and Kaposi's sarcoma). A critical review of the literature is included.
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334
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Newton JA, Spaull J, McGibbon DH, Wilson Jones E. Malignant angiosarcoma of the scalp: a case report with immunohistochemical studies. Br J Dermatol 1985; 112:97-105. [PMID: 3918555 DOI: 10.1111/j.1365-2133.1985.tb02297.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
A case of angiosarcoma of the scalp is reported. The histogenesis of this tumour is discussed in terms of the ultrastructural and immunohistochemical findings. This type of angiosarcoma is uncommon and carries a poor prognosis: the therapeutic alternatives are discussed.
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335
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Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 52-1984. An 86-year-old woman with chronic facial swelling. N Engl J Med 1984; 311:1686-93. [PMID: 6542173 DOI: 10.1056/nejm198412273112608] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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336
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Gibbs AR, Johnson NF, Giddings JC, Powell DE, Jasani B. Primary angiosarcoma of the mediastinum: light and electron microscopic demonstration of Factor VIII-related antigen in neoplastic cells. Hum Pathol 1984; 15:687-91. [PMID: 6430779 DOI: 10.1016/s0046-8177(84)80296-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
An angiosarcoma developed in the superior mediastinum of a 50-year-old white woman. The ultrastructural appearance and the significance of Factor VIII-related antigen within the neoplastic cells are discussed.
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337
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Riccardi VM, Wheeler TM, Pickard LR, King B. The pathophysiology of neurofibromatosis. II. Angiosarcoma as a complication. CANCER GENETICS AND CYTOGENETICS 1984; 12:275-80. [PMID: 6426776 DOI: 10.1016/0165-4608(84)90040-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
A patient with Von Recklinghausen neurofibromatosis and an angiosarcoma (which developed subsequent to two separate neurofibrosarcomas ) is described, and the association of neurofibromatosis and angiosarcoma is reviewed. The data showed that angiosarcoma is not coincidental with neurofibromatosis, and there is a need to focus investigative efforts on the vascular aspects of this disease.
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338
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339
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340
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Messmer EP, Font RL, McCrary JA, Murphy D. Epithelioid angiosarcoma of the orbit presenting as Tolosa-Hunt syndrome. A clinicopathologic case report with review of the literature. Ophthalmology 1983; 90:1414-21. [PMID: 6687155 DOI: 10.1016/s0161-6420(83)34344-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
The clinical diagnosis of Tolosa-Hunt syndrome was first considered in a 66-year-old man with facial pain and diplopia. A complete neuroradiologic evaluation as well as an oncologic work-up yielded normal results. Several courses of oral prednisone provided no significant benefit. Within a year the patient became clinically worse and a CT scan disclosed an abnormal area of enhancement at the left orbital apex. An orbital exploration was performed elsewhere and a histologic diagnosis of myositis was obtained. Because of further worsening the patient was re-evaluated 3 months later and a CT scan showed a mass in the left orbital apex and superior orbital fissure. A second orbital exploration was performed and a sausage-shaped mass encompassing the optic nerve was excised. By light microscopy a poorly differentiated malignant tumor was infiltrating the orbital tissues with areas of intra- and perineural invasion. The tumor cells were arranged in strands and tubules with a definite tendency to form lumens that often contained red blood cells. Electron microscopic studies disclosed features consistent with a neoplasm of endothelial cell origin displaying a polarized basal lamina and rare micropinocytotic vesicles on the luminal side. The presence of multiple, slender microvilli and sometimes tonofilaments as well as desmosomes were interpreted as epithelioid metaplasia of an angiosarcoma.
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341
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Abstract
A 61-year-old woman developed an angiosarcoma in the irradiated chest wall 2 1/2 and 4 years after mastectomy for a carcinoma of breast. The two sets of tumours were morphologically distinct and differed immunohistochemically. The short interval between post-operative irradiation and presentation of the angiosarcoma is unusual. The case is discussed in relation to others of allied type.
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