A Case of Radiation-Induced Multifocal Laryngeal Angiosarcoma Presenting as a Diagnostic Dilemma

Abstract

Head and neck sarcomas are relatively rare tumors, with angiosarcomas representing a small subset. Angiosarcoma is a malignant endothelial neoplasm characterized by atypical, multilayered, or solid endothelial proliferation with vasoformative architecture. The global incidence of irradiation-associated sarcoma is estimated as between 0.03% and 0.08%. Here we reported the case of an elderly woman previously treated with radiation more than 20 years ago for an unknown primary of head and neck. This interesting case presented as a diagnostic challenge, and multiple biopsies were required to eventually establish the diagnosis of laryngeal angiosarcoma. We additionally have confirmation from our prior radiation records that the patient did, in fact, receive a substantial dose of radiation to the site previously. To our knowledge, this case represents the first report of a documented radiation-induced multifocal laryngeal angiosarcoma.

Nasal angiosarcoma metastatic to the larynx: Case report and systematic review of the literature

“…The bibliographies of relevant articles were further reviewed for other references. The variables extracted are listed in Table . Data extraction was performed by 2 of our authors (H.Q.…”

“…The English‐language peer‐reviewed literature yields 17 cases of primary laryngeal angiosarcoma, and no cases of laryngeal metastasis . Data regarding patient demographics, presentation, treatment, and outcome are reported in Table .…”

“…Previously suggested criteria for radiation‐associated sarcoma include: (1) a tumor arising within the previously irradiated field; (2) development at least 3 to 5 years after irradiation; (3) occurrence in a patient who received a substantial amount of irradiation (25–80 Gy); and (4) pathology distinct from the primary tumor . The 17 reported cases of laryngeal angiosarcoma represent both radiation‐associated and nonradiation‐associated malignancies, but no case of angiosarcoma metastasizing to the larynx …”

A Case of Radiation-Associated Angiosarcoma After Laryngeal Cancer

“…[1][2][3] It also can occur in the context of known risk factors including prior radiation therapy. [1][2][3][4][5] There is a limited number of reported cases of angiosarcoma in the head and neck after radiation therapy. [3][4][5][6] Treatment consists of wide local excision, when anatomically feasible, with possible adjuvant radiation therapy.…”

“…1,3,6 Most authors quote 5-year survival less than 35%. 1,[4][5][6] We present a case of a 72-year-old male who presented to our facility in July 2017 with a chief complaint of shortness of breath. His past medical history included total laryngectomy with left pectoralis major muscle local flap reconstruction for recurrent laryngeal cancer in 2010.…”