Increased risk of angiosarcoma secondary to cancer radiotherapy: Case series and review of the treatment options

Abstract

Angiosarcomas (ASs) are aggressive tumors of vascular endothelial origin, occurring sporadically or in association with prior radiotherapy or chronic lymphedema. With only 1–5% of all sarcomas, the incidence seems low, but for the affected patient due to the extremely poor prognosis and the limited treatment options, the fate is often inevitable. Radiotherapy, chemotherapy, or “target therapy” have been used in the management of AS, but represent individual case decisions without lasting evidence. Over the past few years, breast‐conserving surgery followed by radiation therapy, known as breast‐conserving therapy (BCT), is being employed as a standard treatment for early‐stage breast cancer, but there has been an increase in reports of AS following BCT. We report two cases of AS following BCT and one case of primary AS involving the lower limb.

Stewart‐Treves syndrome and other cutaneous malignancies in the context of chronic lymphedema: a systematic review

“…Radiation‐induced angiosarcoma of the breast (RAIS) has been described as a rare complication of radiotherapy for breast cancer, with a 26‐fold increase in risk reported in a retrospective cohort of 194,798 irradiated breast cancer survivors, although the risk of RAIS in the absence of lymphedema could not be isolated 22 . There are, however, case reports of RAIS in patients without lymphedema that may support the systemic carcinogenic hypothesis 23–25 . There was a notable difference in years before malignancy onset in patients with and without cancer histories; malignancies were detected on average 11.9 years from lymphedema onset in patients with cancer histories and in 25.7 years in patients without, potentially caused by systemic carcinogenic factors.…”

Skin Malignancies Due to Anti-Cancer Therapies

“…The incidence of radiation-associated angiosarcoma (RAAS) has increased with the spread of breast-conserving surgery. Although the characteristics of RAAS differ from primary angiosarcoma, the risk does not outweigh the benefits of adjuvant radiotherapy [ 58 ].…”

Primary Epithelioid Angiosarcoma of the Jejunal Mesentery Causing Abdominal Bleeding: Case Report and Literature Review

“… 1 Secondary angiosarcoma is associated with chronic lymphedema and exposure to radioactive substances. 2 Due to the ubiquitous presence of blood vessels and lymphatic vessels, angiosarcoma can occur in any part of the body and is often more common in the skin of the head and neck of elderly people. It presents as a protruding mass, resembling purple black papules.…”