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Hwang G, Shin J, Lee JY, Na KS, Paik JS, Yim HW, Yang SW, Cho WK. The Eyelid Angiosarcoma: A Systematic Review of Characteristics and Clinical Course. J Clin Med 2022; 11:jcm11144204. [PMID: 35887967 PMCID: PMC9320659 DOI: 10.3390/jcm11144204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 07/07/2022] [Accepted: 07/16/2022] [Indexed: 02/01/2023] Open
Abstract
A systematic search for eyelid angiosarcoma was performed from inception to December 2020 in Medline, EMBASE, and the Cochrane databases. Forty two eyelid angiosarcoma cases in 32 articles were analyzed. Eyelid angiosarcomas showed an incidence peak in the eighth decade of life, and was reported more frequently in Caucasian males. Eyelid angiosarcomas were associated with a mortality rate of 26.2%, a recurrence rate of 14.3%, and a cure rate of 45.2%. Four years event-free survival (EFS) rate was 36.0%, with median EFS of 36 months. Eyelid angiosarcomas with bilateral involvement or metastasis showed higher mortality and recurrence rates than unilateral eyelid invasion cases. In the prognosis analysis according to treatment modalities, the mortality and recurrence rates were the lowest in patients who underwent surgical excision. The 4-year EFS probability in a group with surgical excision was 60.6%, but in a group without surgical excision it was 30.3%. A total of 45.2% of the cases was misdiagnosed and 21.4% of the cases could not be correctly diagnosed with the first biopsy trial. The prognosis for eyelid angiosarcomas was better than that of angiosarcomas invading the face and scalp. Surgical excision was the most important treatment modality; thus, should be considered as the first treatment of choice.
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Affiliation(s)
- Gyudeok Hwang
- Department of Ophthalmology, Daejeon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (G.H.); (J.S.); (J.-Y.L.)
| | - Jeongah Shin
- Department of Ophthalmology, Daejeon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (G.H.); (J.S.); (J.-Y.L.)
| | - Ji-Young Lee
- Department of Ophthalmology, Daejeon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (G.H.); (J.S.); (J.-Y.L.)
| | - Kyung-Sun Na
- Department of Ophthalmology, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (K.-S.N.); (J.-S.P.)
| | - Ji-Sun Paik
- Department of Ophthalmology, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (K.-S.N.); (J.-S.P.)
| | - Hyeon Woo Yim
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea;
| | - Suk-Woo Yang
- Department of Ophthalmology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea;
| | - Won-Kyung Cho
- Department of Ophthalmology, Daejeon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (G.H.); (J.S.); (J.-Y.L.)
- Correspondence: ; Tel.: +82-42-220-9590
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Kostaki M, Vourlakou C, Polydorou D, Stratigos AJ. Atypical presentation of cutaneous angiosarcoma: Review of the literature. Clin Exp Dermatol 2022; 47:1636-1641. [PMID: 35548936 DOI: 10.1111/ced.15256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2022] [Indexed: 11/29/2022]
Abstract
Cutaneous angiosarcoma is a quite aggressive tumor of vascular or lymphatic origin. Although relatively rare, it is important to be early recognized and treated. It typically arises on the head or neck as a bruise or raised purplish-red papule or plaque. Sometimes though, it can resemble a benign skin lesion leading to diagnosis delay and poor patient outcome. Angiosarcoma may be mistaken for inflammatory, auto-immune, or infectious disease, benign skin tumor or post-traumatic lesion. Herein we analyze the atypical clinical forms of this aggressive tumor.
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Affiliation(s)
- Maria Kostaki
- First Department of Drmatology-Venereology of Medical School of Athens University, Andreas Syggros Hospital
| | | | - Doris Polydorou
- First Department of Drmatology-Venereology of Medical School of Athens University, Andreas Syggros Hospital
| | - Alexandros J Stratigos
- First Department of Drmatology-Venereology of Medical School of Athens University, Andreas Syggros Hospital
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Chow KY, Ko S, Ang QWM. Rapidly Progressive Periorbital Oedema: A Case of Cutaneous Angiosarcoma. Case Rep Oncol 2021; 14:531-537. [PMID: 33976630 PMCID: PMC8077485 DOI: 10.1159/000514304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 01/11/2021] [Indexed: 11/19/2022] Open
Abstract
Angiosarcoma is a rare form of malignant endothelial cell tumour characterised by rapidly infiltrating anaplastic cells of vascular or lymphatic origin. We report an uncommon case of cutaneous angiosarcoma (cAS) manifesting as rapidly progressive unilateral periorbital oedema. Due to the acute onset of disease, the patient was initially treated with antibiotics for presumed periorbital cellulitis. The lack of response to conservative management raised the suspicion of a more serious condition, which eventually revealed the diagnosis of angiosarcoma through skin biopsy. As suggested by several previous case reports, the subtle manifestation of cAS made it a great mimicker of benign skin conditions. This case report serves as a reminder to the aggressive nature of angiosarcoma which can lead to marked facial swelling within several weeks. As the tumour was not resectable by the time of diagnosis, the patient was offered palliative radiotherapy.
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Affiliation(s)
- Kuan Yee Chow
- Department of Internal Medicine, Ballarat Health Services, Ballarat, Victoria, Australia
| | - Soe Ko
- Department of Internal Medicine, Ballarat Health Services, Ballarat, Victoria, Australia
| | - Qiao Wei Melissa Ang
- Department of Obstetrics and Gynaecology, St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester, United Kingdom
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Abstract
BACKGROUND Cutaneous angiosarcoma presents clinically in numerous ways, and can be mistaken for a different clinical entity, particularly when arising at unusual anatomic locations such as the eyelid. CASE PRESENTATION A 57-year-old woman presented with a 1-year history of eyelid swelling. Concurrent imaging was also suggestive of an edematous process. Multiple superficial biopsies showed nonspecific dermal inflammation and interstitial edema. A diagnosis of Morbihan disease (chronic and idiopathic lymphedema of the eyelid) was rendered, and the patient was treated with compression and local therapy without clinical improvement. Three years after initial presentation, a diagnostic blepharoplasty was performed revealing a deep dermal vascular proliferation composed of anastomosing vascular channels with an atypical endothelial lining. A diagnosis of cutaneous angiosarcoma was ultimately made. CONCLUSIONS This case illustrates a unique presentation of cutaneous angiosarcoma and the implications of different biopsy techniques in acquiring the correct diagnosis.
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Milman T, Shields CL, Brooks JSJ, Lally SE, Shields JA, Tuluc M, Eagle RC. Primary Cutaneous Angiosarcoma of the Eyelid: A Diagnostic and Therapeutic Challenge. Ocul Oncol Pathol 2018; 4:230-235. [PMID: 30643767 DOI: 10.1159/000485427] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 11/16/2017] [Indexed: 11/19/2022] Open
Abstract
Primary cutaneous angiosarcoma is a rare vasoformative malignant neoplasm that can present a diagnostic and therapeutic challenge. We describe a 76-year-old Caucasian man with right upper eyelid swelling and nodularity, initially suspected clinically to represent either ocular adnexal lymphoma or basal cell carcinoma. Incisional biopsy and wide resection of the mass with frozen section control of margins were interpreted as compatible with hobnail (Dabska-retiform) hemangioendothelioma. Foci of atypia were noted in the tumor, raising speculation of evolution into a more aggressive neoplasm, such as conventional angiosarcoma. The patient subsequently underwent two additional wide resections with frozen section control of margins in an attempt to obtain complete excision of residual tumor, which demonstrated histopathologic features favoring angiosarcoma. The histologic material from the original and subsequent resections was sent in consultation to several soft tissue pathology experts and the final diagnosis of low-grade cutaneous angiosarcoma was established. Despite repeated surgical interventions, there was continued persistence of the tumor in the deep orbital tissues. Various management options, including adjuvant radiotherapy/chemotherapy with and without orbital exenteration, were discussed. The patient decided against further surgical intervention and is currently undergoing adjuvant radiotherapy/chemotherapy. This case illustrates the diagnostic and management difficulties of ocular adnexal angiosarcoma.
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Affiliation(s)
- Tatyana Milman
- Department of Ophthalmic Pathology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Carol L Shields
- Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA, USA
| | - John S J Brooks
- Department of Pathology, Pennsylvania Hospital of the University of Pennsylvania Health System, Philadelphia, PA, USA
| | - Sara E Lally
- Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA, USA
| | - Jerry A Shields
- Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA, USA
| | - Madalina Tuluc
- Department of Pathology, Anatomy, and Cell Biology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Ralph C Eagle
- Department of Ophthalmic Pathology, Thomas Jefferson University, Philadelphia, PA, USA
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Hinds B, Banta JC, Brown CA. Acral hyperkeratotic and verrucous plaques in a 77-year-old male patient. Int J Dermatol 2015; 55:e519-21. [PMID: 26513114 DOI: 10.1111/ijd.13108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Accepted: 06/09/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Brian Hinds
- Department of Pathology and Dermatology, University of California San Francisco, San Francisco, CA, USA.
| | - Jonathan C Banta
- School of Medicine, University of Louisville, Louisville, KY, USA
| | - Chad A Brown
- Division of Dermatology, University of Louisville, Louisville, KY, USA
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