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Iacomino E, Fratini C, Sollima L, Eibenstein A, Barbato C, de Vincentiis M, Minni A, Zoccali F. Surgical Resection and Immediate Reconstruction with a Bilayer Wound Collagen Matrix of a Rare Oral Angiosarcoma: A Case Report. Diseases 2024; 12:117. [PMID: 38920549 PMCID: PMC11202842 DOI: 10.3390/diseases12060117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 05/21/2024] [Accepted: 05/23/2024] [Indexed: 06/27/2024] Open
Abstract
Angiosarcomas are malignant vascular tumors that commonly occur on the skin of the head and neck, breast, or scalp. Oral angiosarcoma is a rare tumor (0.0077% of all cancers in Europe), and regarding this atypical localization, no formal treatment trials have been conducted yet. We present a case of a 58-year-old female patient with a diagnosis of oral angiosarcoma. After tumor excision was performed by transoral surgical approach, immediate reconstruction of the intraoral surgical defects was made using Integra® bilayer wound collagen matrix. A skin regeneration technique has previously been reported to provide good healing for defects of buccal resection, preventing postoperative cicatricial fibrosis.
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Affiliation(s)
- Enzo Iacomino
- Department of Life, Health, and Environmental Sciences, Università degli Studi di L’Aquila, 67100 L’Aquila, Italy;
| | - Chiara Fratini
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy; (C.F.); (M.d.V.); (F.Z.)
| | - Laura Sollima
- Anatomy and Pathological Histology Division, ASL 1 Avezzano-Sulmona-L’Aquila, San Salvatore Hospital, 67100 L’Aquila, Italy;
| | - Alberto Eibenstein
- Department of Applied Clinical and Biotechnological Sciences, University of Aquila, 67100 L’Aquila, Italy;
| | - Christian Barbato
- Institute of Biochemistry and Cell Biology (IBBC-CNR), Department of Sense Organs, Sapienza University Rome, Policlinico Umberto I, 00161 Roma, Italy
| | - Marco de Vincentiis
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy; (C.F.); (M.d.V.); (F.Z.)
| | - Antonio Minni
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy; (C.F.); (M.d.V.); (F.Z.)
- Division of Otolaryngology-Head and Neck Surgery, ASL Rieti-Sapienza University, Ospedale San Camillo de Lellis, 02100 Rieti, Italy
| | - Federica Zoccali
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy; (C.F.); (M.d.V.); (F.Z.)
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2
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Nusrath S, Goel V, Raju K, Rao TS, Rao LC, Patnaik SC, Murthy S. Gingival Angiosarcoma: A Case Report and Clinicopathologic Review of 32 Cases of Primary Gingival Angiosarcoma. Indian J Surg Oncol 2020; 11:235-240. [PMID: 32523268 DOI: 10.1007/s13193-020-01032-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 01/02/2020] [Indexed: 11/27/2022] Open
Abstract
Angiosarcoma is a malignant neoplasm of mesenchymal origin arising from vascular endothelium and most commonly involves extremities. Gingival angiosarcoma is a rare sporadic occurring tumor. We report a case of primary angiosarcoma of gingiva along with a review of 31 cases of primary gingival angiosarcoma reported in literature till 2018. A 30-year-old lady presented with recurrent gingival swelling over central mandible. She had no palpable cervical lymphadenopathy. She underwent central marginal mandibulectomy. Final histological analysis with immunohistochemistry was suggestive of the angiosarcoma of the gingiva. She is 50 months postoperative and doing well.
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Affiliation(s)
- Syed Nusrath
- Department of Surgical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Road No 10, Banjara Hills, Hyderabad, India
| | - Vipin Goel
- Department of Surgical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Road No 10, Banjara Hills, Hyderabad, India
| | - Kvvn Raju
- Department of Surgical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Road No 10, Banjara Hills, Hyderabad, India
| | - T Subramanyeshwar Rao
- Department of Surgical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Road No 10, Banjara Hills, Hyderabad, India
| | - Lm Chandrashekhar Rao
- Department of Surgical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Road No 10, Banjara Hills, Hyderabad, India
| | - Sujit Chyau Patnaik
- Department of Surgical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Road No 10, Banjara Hills, Hyderabad, India
| | - Sudha Murthy
- Department of Laboratory Medicine, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, India
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3
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Di Battista M, Darling MR, Scrivener E, Stapleford R, Wehrli B, McCord C. Histologic and Immunopathologic Variability in Primary Intraoral Angiosarcoma: A Case Report and Review of the Literature. Head Neck Pathol 2020; 14:1139-1148. [PMID: 32026293 PMCID: PMC7669916 DOI: 10.1007/s12105-020-01134-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 01/22/2020] [Indexed: 01/01/2023]
Abstract
Primary intraoral angiosarcoma is an exceptionally rare malignancy of vascular origin which can be challenging to diagnose due to microscopic and immunohistochemical variability. A histopathologically challenging case of primary intraoral angiosarcoma, occurring in a pediatric patient is presented. A comprehensive review of the literature reveals that primary intraoral angiosarcomas occur with nearly equal frequency in males and females, affect the gingiva and the tongue most commonly and are treated primarily with surgery. As with angiosarcoma in other sites, primary intraoral angiosarcoma behaves aggressively with the majority of patients succumbing to their disease.
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Affiliation(s)
| | - Mark R. Darling
- Department of Dentistry, Schulich School of Medicine and Dentistry, Western University, London, ON Canada ,Division of Oral Pathology, Department of Pathology and Laboratory Medicine, Western University, 1151 Richmond Street, London, ON N6A 4C1 Canada ,Department of Pathology and Laboratory Medicine, London Health Sciences Centre, London, ON Canada
| | | | - Richard Stapleford
- Great Lakes Oral and Maxillofacial Surgery Centre, Windsor, ON Canada ,Department of Oral and Maxillofacial Surgery and Dentistry, Windsor Regional Hospital, Windsor, ON Canada
| | - Bret Wehrli
- Department of Pathology and Laboratory Medicine, London Health Sciences Centre, London, ON Canada
| | - Christina McCord
- Department of Dentistry, London Health Sciences Centre, London, ON Canada ,Department of Dentistry, Schulich School of Medicine and Dentistry, Western University, London, ON Canada ,Division of Oral Pathology, Department of Pathology and Laboratory Medicine, Western University, 1151 Richmond Street, London, ON N6A 4C1 Canada ,Department of Pathology and Laboratory Medicine, London Health Sciences Centre, London, ON Canada
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4
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Berger GK, Gee K, Votruba C, McBride A, Anwer F. Potential application and prevalence of the CD30 (Ki-1) antigen among solid tumors: A focus review of the literature. Crit Rev Oncol Hematol 2017; 113:8-17. [PMID: 28427526 DOI: 10.1016/j.critrevonc.2017.02.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Revised: 01/26/2017] [Accepted: 02/15/2017] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND CD30 (Ki-1) is a cell membrane protein derived from the tumor necrosis factor (TNF) receptor family. The CD30 antigen has been associated primarily with Hodgkin lymphoma (HL) and systemic anaplastic large cell lymphoma (sALCL). Brentuximab vedotin (BV) is an antibody-drug conjugate targeting the CD30 antigen. FDA approval for BV includes relapsed and refractory HL and sALCL. The CD30 antigen also has been identified in many solid tumors, predominantly of germ cell origins and early clinical data is promising. OBJECTIVE Perform a focus literature review evaluating the prevalence of the CD30 antigen among nonlymphomatous tumors with a potential correlate for CD30 targeted therapy. ELIGIBILITY CRITERIA Inclusion criteria: all retrospective reviews and case reports citing CD30 positivity or negativity in non-lymphomatous malignancies in which data were presented based on location. EXCLUSION CRITERIA studies with hematopoetic malignancies, cutaneous malignancies, non-human populations, and non-english publications. INCLUDED STUDIES A total of 119 articles met these criteria and are summarized in this manuscript. CONCLUSION The CD30 antigen has shown variable prevalence among non-hematopoetic tumors, most notably among germ cell tumors and mesothelioma. With additional, preclinical and properly powered clinical studies, CD30 targeted therapy such as that of BV, alone or in combination with other agents may prove to be a strong candidate in the treatment of various CD30+ malignancies.
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Affiliation(s)
- Garrett K Berger
- College of Pharmacy, University of Arizona, Tucson, AZ, 85721, United States; Hematology, Oncology, Blood & Marrow Transplantation, Department of Medicine, University of Arizona, Tucson, AZ, 85721, United States.
| | - Kevin Gee
- College of Medicine, University of Arizona, Tucson, AZ, 85721, United States
| | - Cassandra Votruba
- College of Pharmacy, University of Arizona, Tucson, AZ, 85721, United States
| | - Ali McBride
- College of Pharmacy, University of Arizona, Tucson, AZ, 85721, United States; Hematology, Oncology, Blood & Marrow Transplantation, Department of Medicine, University of Arizona, Tucson, AZ, 85721, United States
| | - Faiz Anwer
- Hematology, Oncology, Blood & Marrow Transplantation, Department of Medicine, University of Arizona, Tucson, AZ, 85721, United States
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5
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Doeuk C, McNamara Z, Taheri T, Batstone MD. Primary angiosarcoma of the mandible: a case report. J Oral Maxillofac Surg 2014; 72:2499.e1-7. [PMID: 25315306 DOI: 10.1016/j.joms.2014.07.035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Revised: 07/28/2014] [Accepted: 07/28/2014] [Indexed: 10/25/2022]
Abstract
Angiosarcomas are rare but aggressive vascular cancers of endothelial cell origin. Characteristically, they have a high local recurrence rate and an early metastatic potential. They rarely migrate to the skeleton, and even more unlikely, they may originate in the bones of the face. We present a rare occurrence of a primary angiosarcoma of the mandible. This case highlights the scarce literature available and difficulties in diagnosing and managing this aggressive tumor.
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Affiliation(s)
- Celine Doeuk
- Resident Medical Officer, Department of Oral and Maxillofacial Surgery, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.
| | - Zeb McNamara
- Registrar, Department of Oral and Maxillofacial Surgery, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Touraj Taheri
- Staff Specialist, Department of Anatomical Pathology, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Martin D Batstone
- Head of Department, Department of Oral and Maxillofacial Surgery, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
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6
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Dive AM, Bodhade AS, Mishra MS, Upadhyaya N. Histological patterns of head and neck tumors: An insight to tumor histology. J Oral Maxillofac Pathol 2014; 18:58-68. [PMID: 24959039 PMCID: PMC4065450 DOI: 10.4103/0973-029x.131912] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
This article emphasizes the basis for origin and importance of tumor patterns in diagnosis of oral and maxillofacial tumors. In this article, histological patterns and subpatterns of head and neck tumors are enlisted. Although, undifferentiated tumors remain a challenge to the histopathologist, by describing the histological patterns and the subpatterns of the tumors, an attempt has been made for the diagnosis of the tumors and subsequently for implementation of precise treatment plan for the same.
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Affiliation(s)
- Alka M Dive
- Department of Oral and Maxillofacial Pathology, Vidya Shikshan Prasarak Mandal's Dental College and Research Centre, Nagpur, Maharashtra, India
| | - Ashish S Bodhade
- Department of Oral and Maxillofacial Pathology, Vidya Shikshan Prasarak Mandal's Dental College and Research Centre, Nagpur, Maharashtra, India
| | - Minal S Mishra
- Department of Oral and Maxillofacial Pathology, Vidya Shikshan Prasarak Mandal's Dental College and Research Centre, Nagpur, Maharashtra, India
| | - Neha Upadhyaya
- Department of Oral and Maxillofacial Pathology, Vidya Shikshan Prasarak Mandal's Dental College and Research Centre, Nagpur, Maharashtra, India
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7
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Nagata M, Yoshitake Y, Nakayama H, Yoshida R, Kawahara K, Nakagawa Y, Shinohara M. Angiosarcoma of the oral cavity: a clinicopathological study and a review of the literature. Int J Oral Maxillofac Surg 2014; 43:917-23. [PMID: 24656496 DOI: 10.1016/j.ijom.2014.02.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Revised: 02/06/2014] [Accepted: 02/10/2014] [Indexed: 10/25/2022]
Abstract
Soft tissue sarcomas are uncommon in the head and neck. Primary angiosarcomas of the oral cavity area are extremely rare, and have mostly been presented as case reports. This paper presents the clinical and histological features of three such cases. All patients were diagnosed based on the presence of rapidly extending masses involving the tongue, maxillary gingiva, or mandibular gingiva; bone destruction was present in two cases. The resected specimens revealed clustered large, pleomorphic, and spindle-shaped cells with a markedly haemorrhagic background. Tumour cells showed expression of vascular endothelial markers, such a CD31, CD34, and factor VIII-related antigen. Despite undergoing radical surgery, distant metastases developed in all three cases. We also studied the clinicopathological features of a series of oral angiosarcomas. This article therefore reports the clinicopathological features of the three new cases and provides a review of the cases of primary oral angiosarcoma reported during the past 20 years.
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Affiliation(s)
- M Nagata
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
| | - Y Yoshitake
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - H Nakayama
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - R Yoshida
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - K Kawahara
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Y Nakagawa
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - M Shinohara
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
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8
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Gogia A, Bansal A, Suri V, Bakhshi S. Childhood orbital soft tissue sarcoma in xeroderma pigmentosum with good tolerance to chemotherapy and radiotherapy. Pediatr Blood Cancer 2013; 60:2093-4. [PMID: 23946134 DOI: 10.1002/pbc.24716] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Accepted: 07/12/2013] [Indexed: 11/10/2022]
Affiliation(s)
- Ajay Gogia
- Department of Medical Oncology, Dr. B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
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9
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Pathogenesis of human hemangiosarcomas and hemangiomas. Hum Pathol 2013; 44:2302-11. [DOI: 10.1016/j.humpath.2013.05.012] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Revised: 05/16/2013] [Accepted: 05/17/2013] [Indexed: 12/29/2022]
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10
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Kakiuchi-Kiyota S, Crabbs TA, Arnold LL, Pennington KL, Cook JC, Malarkey DE, Cohen SM. Evaluation of expression profiles of hematopoietic stem cell, endothelial cell, and myeloid cell antigens in spontaneous and chemically induced hemangiosarcomas and hemangiomas in mice. Toxicol Pathol 2012; 41:709-21. [PMID: 23125116 DOI: 10.1177/0192623312464309] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
It is unclear whether the process of spontaneous and chemically induced hemangiosarcoma and hemangioma formation in mice involves the transformation of differentiated endothelial cells (ECs) or recruitment of multipotential bone marrow-derived hematopoietic stem cells or endothelial progenitor cells (EPCs), which show some degree of endothelial differentiation. In the present study, immunohistochemical staining for hematopoietic stem cell markers (CD45 and CD34), EC markers (vascular endothelial growth factor receptor 2 [VEGFR2], CD31, and factor VIII-related antigen), and a myeloid lineage marker (CD14) was employed to better define the origin of hemangiosarcomas and hemangiomas in mice. Staining was negative for CD45, factor VIII-related antigen, and CD14 and positive for CD34, VEGFR2, and CD31, indicating that mouse hemangiosarcomas and hemangiomas are composed of cells derived from EPCs expressing CD34, VEGFR2, and CD31 but not factor VIII-related antigen. The lack of CD45 expression suggests that mouse vascular tumors may arise from EPCs that are at a stage later than hematopoietic stem cells. Since factor VIII-related antigen expression is known to occur later than CD31 expression in EPCs, our observations may indicate that these tumor cells are arrested at a stage prior to complete differentiation. In addition, myeloid lineage cells do not appear to contribute to hemangiosarcoma and hemangioma formation in mice.
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Affiliation(s)
- Satoko Kakiuchi-Kiyota
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, Nebraska, USA
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12
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Sumida T, Murase R, Fujita Y, Ishikawa A, Hamakawa H. Epulis-like gingival angiosarcoma of the mandible: a case report. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2012; 5:830-833. [PMID: 23074540 PMCID: PMC3466989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/16/2012] [Accepted: 09/05/2012] [Indexed: 06/01/2023]
Abstract
A 55-year-old woman consulted our hospital for an epulis-like small mass in the anterior region of the mandible. A biopsy of the tumor was performed. Histological analysis showed that the tumor consisted of spindle-shaped and polygonal cells with hyperchromatic nuclei, and intracytoplasmic vacuoles and mitotic figures were scattered. Immunohistochemical staining revealed that the tumor cells were positive for factor VIII-related antigen, CD31, αSMA, and vimentin, but negative for pancytokeratins, S100 protein, neuron-specific enolase, and CD56. The Ki-67 labeling index was more than 50%. Based on these findings, a final pathological diagnosis of angiosarcoma was made. The tumor did not invade into the surrounding tissue. The operation was performed with about a 20-mm surgical margin that was negative for tumor invasion. After a 4-year follow-up, no metastatic lesions were found, and the primary site was covered with a partial denture.
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Affiliation(s)
- Tomoki Sumida
- Department of Oral and Maxillofacial Surgery, Ehime University Graduate School of Medicine, Toon-city, Ehime Japan.
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13
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Lin XY, Liu Y, Zhang Y, Yu JH, Wang EH. The co-expression of cytokeratin and p63 in epithelioid angiosarcoma of the parotid gland: a diagnostic pitfall. Diagn Pathol 2012; 7:118. [PMID: 22943673 PMCID: PMC3487964 DOI: 10.1186/1746-1596-7-118] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2012] [Accepted: 08/10/2012] [Indexed: 01/21/2023] Open
Abstract
Summary Epithelioid angiosarcoma of the parotid gland is rare, and may pose a great diagnostic challenge. We report a case of primary epithelioid angiosarcoma in a 64-year-old male without history of radiation. The histopathological findings demonstrated a high grade epithelioid neoplasm. Immunostaining showed that the tumor was positive for the pan-cytokeratin, p63, cytokeratin18, Vimentin and vascular markers CD31, and was negative for CD34, cytokeratin5/6, cytokeratin7, cytokeratin20, CD68, CD30, S-100, HMB45, desmin, α–SMA and CD45. The tumor was diagnosed as an epithelioid angiosarcoma. To our knowledge, this is the first reported case of angiosarcoma which showed common positivity for cytokeratin and p63. In addition to cytokeratin, p63 is considered a useful marker for carcinoma. The co-expression of cytokeratin and p63 in epithelioid angiosarcoma represents a diagnostic pitfall. Thus, using a panel of antibodies is essential for distinguishing this tumor from poorly differentiated carcinoma. Virtual Slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/6548916707504750
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Affiliation(s)
- Xu-Yong Lin
- Department of Pathology, The First Affiliated Hospital and College of Basic Medical Sciences, China Medical University, Shenyang, 110001, China
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14
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Karube R, Sasaki H, Shinozuka K, Fujisawa Y, Yanagawa T, Yamagata K, Onizawa K, Otsuka F, Bukawa H. Angiosarcoma of the scalp diagnosed by the presence of neck inflammation: a case report. Int J Oral Sci 2012; 4:166-9. [PMID: 22699262 PMCID: PMC3465010 DOI: 10.1038/ijos.2012.36] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Angiosarcoma is an uncommon malignancy, which spread out from the endothelial cells of vessels. Scalp angiosarcoma with cervical lymph node metastasis is particularly rare. This article describes a rare case of angiosarcoma of the scalp, presenting as neck inflammation. Imaging procedures such as computed tomography (CT), magnetic resonance image (MRI) and ultrasonography (US) were not sufficient to diagnose this case. A needle biopsy provided an effective and accurate diagnosis of cervical lymph node metastasis. Additional observation and physical examination was required to diagnose the origin of the primary cancerous lesion. Once the angiosarcoma diagnosis was confirmed histologically, sequential weekly and monthly docetaxel (DTX) treatment was effective in preventing reoccurrence. Nonetheless, the optimization of angiosarcoma treatment remains a future goal. Although patients generally describe pain and swelling at the primary lesion site, this patient complained only of painful neck inflammation, without any indication of pain or swelling of the scalp. A revised diagnostic protocol should note that cervical lymph node metastasis of unknown primary origin may result from angiosarcoma of the scalp.
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Affiliation(s)
- Rei Karube
- Department of Oral and Maxillofacial Surgery, University of Tsukuba, Tsukuba City, Japan
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15
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Abstract
Primary angiosarcoma of the breast is a rare tumour that account for fewer than 0.05% of all malignant mammary tumours. Angiosarcoma may have an perfidious clinical onset. Radiologic findings are often nonspecific and may appear completely normal in one-third of cases with primary angiosarcoma. The prognosis is usually poor because of the high rates of local recurrence and early development of metastases. Aggressive surgical resection is the mainstay of treatment. The role of adjuvant therapy has not yet been well established. Here we present a case of a 53 year old, postmenopausal women with primary angiosarcoma arising in fibroadenoma. To our knowledge, this is the first case described in the literature to date.
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16
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Terada T. Angiosarcoma of the mandibular gingiva. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2011; 4:791-793. [PMID: 22135727 PMCID: PMC3225791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/12/2011] [Accepted: 10/22/2011] [Indexed: 05/31/2023]
Abstract
Angiosarcoma of the oral cavity is extremely rare. A 77-year-old woman consulted to our hospital because of polypoid mass of the mandibular gingival. Physical examination showed polypoid reddish mass measuring 1.5 × 1.5 × 1 cm in the mandibular gingival posterior to the front tooth. Enucleation of the tumor was performed. Grossly, the tumor was not encapsulated. Histologically, the tumor consisted of atypical spindle with hyperchromatic nuclei with nucleoli. Mitotic figures were scattered. Vasoformative channels were present in some areas. The surgical margins were positive. Immunohistochemically, the tumor cells were positive for factor VIII-related antigen, CD31, CD34, vimentin, p53 protein, but negative for pancytokeratin (AE1/3 and CAM5.2), S100 protein, α-smooth muscle antigen, and desmin. The Ki-67 labeling was 60%. A pathological diagnosis of angiosarcoma was made. Radical operation is planned now.
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Affiliation(s)
- Tadashi Terada
- Department of Pathology, Shizuoka City Shimizu Hospital Shizuoka, Japan.
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17
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Olson MT, Puttgen KB, Westra WH. Angiosarcoma arising from the tongue of an 11-year-old girl with xeroderma pigmentosum. Head Neck Pathol 2011; 6:255-7. [PMID: 21987224 PMCID: PMC3370034 DOI: 10.1007/s12105-011-0303-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2011] [Accepted: 09/26/2011] [Indexed: 11/26/2022]
Abstract
Xeroderma pigmentosum (XP) is a rare autosomal recessive defect in DNA endonuclease activity that is associated with the development of cutaneous malignancies, at sun exposed sites, including basal cell carcinoma, squamous cell carcinoma, and melanoma. Squamous cell carcinomas are also known to target the anterior tongue. Patients sometimes develop angiosarcomas, and these invariably arise from sun-exposed skin. A biopsy was taken from a large mass arising in the anterior tongue of an 11-year-old girl with XP and a history of cutaneous basal cell carcinomas. The histopathologic findings demonstrated a high grade epithelioid neoplasm resembling a poorly differentiated squamous cell carcinoma, but the immunohistochemical profile (AE1/AE3 negative, p63 negative, CD31 positive, CD34 positive) established the diagnosis of angiosarcoma. Angiosarcoma is an XP-related tumor that usually arises in sun-exposed skin but can also arise in the oral cavity. For patients with XP who develop epithelioid neoplasms of the oral cavity, epithelioid angiosarcoma should be considered in the differential diagnosis.
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Affiliation(s)
- Matthew T. Olson
- Departments of Pathology, The Johns Hopkins University School of Medicine, 401 N. Broadway, Weinberg 2242, Baltimore, MD 21231 USA
| | - Katherine B. Puttgen
- Departments of Dermatology, The Johns Hopkins Medical Institutions, Baltimore, MD USA
| | - William H. Westra
- Departments of Pathology, The Johns Hopkins University School of Medicine, 401 N. Broadway, Weinberg 2242, Baltimore, MD 21231 USA
- Departments of Dermatology, The Johns Hopkins Medical Institutions, Baltimore, MD USA
- Departments of Oncology, The Johns Hopkins Medical Institutions, Baltimore, MD USA
- Departments of Otolaryngology/Head and Neck Surgery, The Johns Hopkins Medical Institutions, Baltimore, MD USA
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Kallen ME, Nunes Rosado FG, Gonzalez AL, Sanders ME, Cates JMM. Occasional Staining for p63 in Malignant Vascular Tumors: A Potential Diagnostic Pitfall. Pathol Oncol Res 2011; 18:97-100. [DOI: 10.1007/s12253-011-9426-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2011] [Accepted: 05/31/2011] [Indexed: 10/18/2022]
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