Spontaneous Regression of Epithelioid Angiosarcoma in a Young Woman

Abstract

A 20-year-old Japanese woman with a history of pulmonary atresia was referred to our hospital after the detection of an abnormal mass in the right lung and mediastinal lymphadenopathy. A cytological specimen obtained by transbronchial brushing indicated that the pathological diagnosis was non-small cell lung cancer. During the follow-up period, the tumor spontaneously regressed. At four months after the diagnosis, she experienced sudden bleeding from the small intestine. The histological characteristics of the small intestine tumor were compatible with the cytological characteristics of the lung tumor. Detailed immunohistochemical analyses led to a final diagnosis of epithelial angiosarcoma of the small intestine, which might have formed metastatic lesions in the lung.

Spontaneous Regression of Multiple Pulmonary Metastasis of Sacral Chordoma

“…To the best of our knowledge, 21 reports have been published since 1990. The pathological diagnoses in these cases varied, including 3 cases each of angiosarcoma 9-11 and osteosarcoma 12,13 ; 2 cases each of extraskeletal osteosarcoma 14,15 , leiomyosarcoma 16,17 , epithelioid angiosarcoma 18,19 , and chordoma 20,21 ; and 1 case of chondrosarcoma 22 , extraskeletal myxoid chondrosarcoma 23 , fibrosarcoma 24 , infantile fibrosarcoma 25 , myxofibrosarcoma 26 , alveolar soft part sarcoma 27 , and synovial sarcoma 28 . Thus, there is no specific pathological diagnosis that tends to exhibit SR (Table I).…”

Primary small intestinal epithelioid angiosarcoma: a potential diagnostic pitfall due to abnormal expression of cytokeratin

“…The main clinical features included gastrointestinal bleeding (black stool, hematochezia or occult bleeding), abdominal discomfort/pain, and abdominal mass. Other symptoms included intestinal obstruction, diarrhea and weight loss, nausea/vomiting, acute abdomen,bowel perforation,skin pallor/ anemia, etc [2][3][4][5][6][7][8]. Some early cases were even asymptomatic and were occasionally found in routine endoscopy [16].…”

“…Prognosis in advanced diseases is very poor despite the use of surgery, chemotherapy and even radiotherapy. Surprisingly, there is a case of spontaneous regression of pulmonary metastatic EAS from the small intestine [5]. Abdominal CT showed that the intestinal wall of the upper jejunum was thickened near the duodenum.…”

“…Small intestinal AS is very rare. To the best of our knowledge,only 66 cases of small intestinal angiosarcoma including primary or metastatic were reported in the current literature,most had only been found in scattered case reports and small series [3][4][5][6][7][8]. Pathologically AS can be classified into well-differentiated, poorly differentiated,and epithelioid AS.…”

Spontaneous Regression of Myxofibrosarcoma of the Thigh after Open Biopsy

“…Reported number of spontaneous regressions varies widely depending on the type of cancer, with large number of reports in renal cell cancer, malignant melanoma and lymphoma [5]. Although the mechanism behind spontaneous regression is unknown, it has been hypothesized as due to influence of hormone, involvement of immune modulation, trauma, blood flow disorder, infection and emergence of paraneoplastic syndrome [6, 7]. Among the various possibilities, enhancement of the immune system has been suggested to play an important role in both the progression and regression of cancers.…”