Spindle cell angiosarcoma following irradiation therapy for cervical carcinoma

Kiyohara, Takahiro; Kumakiri, Masanobu; Kobayashi, Hitoshi; Itoh, Kei; Lao, Li-Min; Ohkawara, Akira; Nakamura, Hideki

doi:10.1034/j.1600-0560.2002.290206.x

Cited by 21 publications

(10 citation statements)

References 19 publications

(22 reference statements)

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“…Chronic lymphedema is a well‐documented risk factor for the development of angiosarcoma 1 . Lymphedema‐associated angiosarcomas have classically been regarded as a potential complication of surgery for breast carcinoma, constituting a phenomenon known as the Stewart–Treves syndrome, 2 but may also occur as a complication of lymphedema induced secondarily by essentially any cause 1,3–6 . The precise mechanism underlying lymphedema‐associated angiosarcoma is unclear.…”

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confidence: 99%

Cutaneous angiosarcoma arising in massive localized lymphedema of the morbidly obese: a report of five cases and review of the literature

et al. 2011

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A significant proportion of angiosarcoma arises in the setting of chronic lymphedema, often following surgery for breast carcinoma (Stewart-Treves syndrome). Massive localized lymphedema (MLL), a relatively recently described and rare pseudotumor most often occurring in morbidly obese patients, is thought to be the result of derangements in lymphatic drainage secondary to excessive adipose tissue. Only a very small number of cases of angiosarcoma have been reported in patients with MLL. We reviewed the clinical and pathological features of five patients with angiosarcoma arising in this unusual clinical setting. The tumors arose in three women and two men, who were in the age range from 36 to 81 years (median: 52 years). All patients were or had recently been morbidly obese (mean body mass index = 47.2 kg/cm(2) ; range:37.6-68.5 kg/cm(2) ) and had long-standing soft tissue changes of MLL. The tumors arose in the thigh (two cases), lower leg (two cases) and abdomen/proximal thigh (one case) and ranged from 6 to 28.5 cm in size (mean: 15.9 cm). All tumors were conventional high-grade angiosarcomas and microscopically exhibited an admixture of vasoformative, spindled and epithelioid features. Microscopic changes of MLL, including dermal fibrosis, expansion of interlobular fibrous septa and lymphangiectasia, were identified in all cases. Clinical follow-up (four cases; mean: 13.8 months; range: 2-32 months) showed one patient to be dead of disease, one patient to be dead from therapy-related complications and two patients to be alive without disease. One case was too recent for meaningful clinical follow-up. We conclude that lymphedema secondary to obesity should be recognized as a significant risk factor for the development of angiosarcoma. The clinical and pathological features of angiosarcoma arising in this distinctive clinical setting appear to be identical to those of other lymphedema-associated angiosarcomas. With the continuing epidemic of obesity in Western societies, the incidence of obesity-related angiosarcoma is probably to increase. Consequently, it is critical that lymphedematous areas in obese patients be carefully examined for clinical evidence of early angiosarcoma, with the hope that timely diagnosis may lead to improved patient outcome.

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Cutaneous angiosarcoma arising in massive localized lymphedema of the morbidly obese: a report of five cases and review of the literature

et al. 2011

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“…In only a tiny part of the tumor, in the subpapillary dermis, the tumor cells showed vascular channel formation and the morphology of a conventional angiosarcoma ( figure 1E). Spindle cell angiosarcoma, which we experienced, is an extremely rare variant of angiosarcoma and, to date, only a small number of cases have been reported [1,2]. Granular cell angiosarcoma consists predominantly of cells with abundant granular cytoplasm that stain positively with markers for lysosome (CD68, NKI/C3) [3].…”

Section: Spindle Cell Angiosarcoma Almost Exclusively Made Up Of Spinmentioning

confidence: 90%

“…Cases of angiosarcoma exhibiting a significant spindle cell component have been described as spindle cell angiosarcoma [1,2]. In some cases, the growth pattern is predominantly solid, the tumor being composed of polygonal or spindle cells.…”

Section: Spindle Cell Angiosarcoma Almost Exclusively Made Up Of Spinmentioning

confidence: 99%

“…Angiosarcoma shows several rare variants: a spindle cell variant, a granular cell variant [3], a foamy cell variant [4] and a signet ring cell variant [5]. It is very difficult to make the diagnosis only by histopathological features [2]. Foamy cell angiosarcoma is made up of cells with abundant vacuolated cytoplasm and resembling foamy histiocytes [4].…”

Section: Spindle Cell Angiosarcoma Almost Exclusively Made Up Of Spinmentioning

confidence: 99%

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Spindle cell angiosarcoma almost exclusively made up of spindle cells

Makita

Kono²,

Yamada

et al. 2014

European Journal of Dermatology

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with AI, neoplastic cells express CD30 antigen. Although the specific pathogenesis of this association remains to be elucidated and several complex factors appear to be involved, some hypotheses have already been proposed, including: secretion of several growth factors by tumor cells; diminished expression of filaggrin; abnormal vitamin A metabolism; impaired dermal lipogenesis [1,[7][8][9]. In conclusion, AI related to primary cutaneous CD30 + LPDs can represent a paraneoplastic syndrome that generally mirrors the course of the underlying cutaneous lymphoid proliferation. However, in this clinical setting is essential to rule out an ichthyosiform MF.

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“…Previous authors have suggested the following criteria for diagnosing radiotherapy-associated sarcoma [7]:…”

Section: Discussionmentioning

confidence: 99%

Two cases of radiation-induced cutaneous angiosarcoma

et al. 2012

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We report two cases of radiation-induced cutaneous angiosarcoma that occurred years after radiotherapy for pelvic cancer. The tumors in both cases were inoperable because of the poor performance status of the patient or the extent of the lesion. We treated the tumors with concurrent chemotherapy and radiotherapy. The chemotherapy consisted of the weekly administration of 70 mg/m 2 paclitaxel. Both patients received radiotherapy at the prescribed dose of 50 Gy in 2.0-Gy fractions. Two months after the treatment, the lesions of both cases diminished or disappeared. However, a few months after the treatment, both patients suffered from in-field local recurrence and distant metastases, and they subsequently died of their distant metastases. The initial responses of two cases to concurrent chemoradiotherapy were good, and their quality of life was improved without severe complication. Although the long-term control of radiation-induced cutaneous angiosarcoma was difficult, chemoradiotherapy was one of the safe and effective palliative treatments.

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Spindle cell angiosarcoma following irradiation therapy for cervical carcinoma

Abstract: Radiation-induced lymphedema may be a factor in angiosarcoma associated with radiotherapy.

Cited by 21 publications

References 19 publications

Cutaneous angiosarcoma arising in massive localized lymphedema of the morbidly obese: a report of five cases and review of the literature

Cutaneous angiosarcoma arising in massive localized lymphedema of the morbidly obese: a report of five cases and review of the literature

Spindle cell angiosarcoma almost exclusively made up of spindle cells

Two cases of radiation-induced cutaneous angiosarcoma

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