Cutaneous Angiosarcoma of Head and Neck – A Single-Centre Analysis

  • Uwe Wollina Academic Teaching Hospital DresdenDepartment of Dermatology and Allergology
  • André Koch Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Academic Teaching Hospital
  • Gesina Hansel Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Academic Teaching Hospital
  • Jacqueline Schönlebe Institute of Pathology “Georg Schmorl”, Städtisches Klinikum Dresden, Academic Teaching Hospital
  • Torello Lotti Department of Dermatology, University of Rome “G. Marconi”, Rome, Italy
  • Aleksandra Vojvodic Military Medical Academy of Belgrade, Serbia, and University of Rome Guglielmo Marconi Rome, Italy
Keywords: Sarcoma, Cutaneous angiosarcoma, Head and neck region, Histology, Treatment, Outcome

Abstract

BACKGROUND: Cutaneous angiosarcoma of the head and neck region is a subtype of cutaneous angiosarcoma with an unfavourable prognosis. Diagnosis is often delayed.

PATENTS AND METHODS: The setting is an Academic Teaching Hospital Skin Cancer Center. Eight Caucasian patients could be identified, 5 men and 3 women. Delay to diagnosis was between 12 to 4 months (mean 7.8 ± 2.9 months). The diagnosis was confirmed in all cases by histopathology and immunohistochemistry. Hematoxylin-eosin, Giemsa, PAS, iron and reticulin stains were performed. Endothelial markers such as CD31, CD34, and Ki67 for proliferation assessment were used in all tumours. Other markers used included pan-cytokeratin (CK), CK7, CK20, ERG, CD 40 and c-MYC. Tumours were classified as localised versus multifocal or diffuse form. Tumour staging was performed according to the 8th edition of the AJCC. The mean age of patients was 79 years ± 26.4 years. The male to female ratio was 1.7. Tumour classification was diffuse in 2 patients, multilocular in one and localised in 5 patients. In 5 of 8 patients, a multimodal treatment was performed, one had radiotherapy alone, in another patient surgery was performed, and radiotherapy is planned. The mean OS was 26.4 months ± 24.5 months.

CONCLUSION: Cutaneous angiosarcoma of the head and neck is an aggressive tumour with a poor prognosis. Although surgery remains a cornerstone of treatment, the tumour size at first presentation may be too large, and the elderly patients maybe not suitable for extensive surgery. Therefore, multimodal treatment with adjuvant radiotherapy and/ or chemotherapy is necessary. Multimodal treatment offers a better outcome than radiotherapy or chemotherapy alone. Stealth liposomal encapsulated doxorubicin is a therapeutic option for elderly patients with improved safety compared to conventional doxorubicin.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

Author Biographies

Uwe Wollina, Academic Teaching Hospital DresdenDepartment of Dermatology and Allergology

Head of Department of Dermatology and Allergology

André Koch, Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Academic Teaching Hospital

Senior advisor

 

Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Academic Teaching Hospital

Gesina Hansel, Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Academic Teaching Hospital

Senior Advisor

Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Academic Teaching Hospital

Jacqueline Schönlebe, Institute of Pathology “Georg Schmorl”, Städtisches Klinikum Dresden, Academic Teaching Hospital

Senior Advisor

Institute of Pathology “Georg Schmorlâ€, Städtisches Klinikum Dresden, Academic Teaching Hospital

Torello Lotti, Department of Dermatology, University of Rome “G. Marconi”, Rome, Italy

Professor of Dermatology

 

Department of Dermatology, University of Rome “G. Marconiâ€, Rome, Italy

Aleksandra Vojvodic, Military Medical Academy of Belgrade, Serbia, and University of Rome Guglielmo Marconi Rome, Italy

Professor of Dermatology

 

Military Medical Academy of Belgrade, Serbia, and University of Rome Guglielmo Marconi Rome, Italy

References

Young RJ, Brown NJ, Reed MW, Hughes D, Woll PJ. Angiosarcoma. Lancet Oncol. 2010; 11(10):983-91. https://doi.org/10.1016/S1470-2045(10)70023-1

Albores-Saavedra J, Schwartz AM, Henson DE, Kostun L, Hart A, Angeles-Albores D, Chablé-Montero F. Cutaneous angiosarcoma. Analysis of 434 cases from the Surveillance, Epidemiology, and End Results Program, 1973-2007. Ann Diagn Pathol. 2011; 15(2):93-7. https://doi.org/10.1016/j.anndiagpath.2010.07.012 PMid:21190880

Bernstein JM, Irish JC, Brown DH, Goldstein D, Chung P, Razak ARA, Catton C, Gilbert RW, Gullane PJ, O'Sullivan B. Survival outcomes for cutaneous angiosarcoma of the scalp versus face. Head Neck. 2017; 39(6):1205-1211. https://doi.org/10.1002/hed.24747 PMid:28398688

Amin MB, Greene FL, Edge S, Schilsky RL, Gaspar LE, Washington MK, Sullivan DC, Brookland RK. AJCC Cancer Staging Manual, 8th Edition. Springer International, New York, 2017.

Oashi K, Namikawa K, Tsutsumida A, Takahashi A, Itami J, Igaki H, Inaba K, Yamazaki N. Surgery with curative intent is associated with prolonged survival in patients with cutaneous angiosarcoma of the scalp and face -a retrospective study of 38 untreated cases in the Japanese population. Eur J Surg Oncol. 2018; 44(6):823-829. https://doi.org/10.1016/j.ejso.2018.02.246 PMid:29555155

Wollina U, Hansel G, Schönlebe J, Averbeck M, Paasch U, Uhl J, Hindemann W, Simon J-C. Cutaneous angiosarcoma is a rare aggressive malignant vascular tumour of the skin. J Eur Acad Dermatol Venereol. 2011; 25(8):964-8. https://doi.org/10.1111/j.1468-3083.2010.03905.x PMid:21108661

Patel SH, Hayden RE, Hinni ML, Wong WW, Foote RL, Milani S, Wu Q, Ko SJ, Halyard MY. Angiosarcoma of the scalp and face: the Mayo Clinic experience. JAMA Otolaryngol Head Neck Surg. 2015; 141(4):335-40. https://doi.org/10.1001/jamaoto.2014.3584 PMid:25634014

Hwang K, Kim MY, Lee SH. Recommendations for therapeutic decisions of angiosarcoma of the scalp and face. J Craniofac Surg. 2015; 26(3):e253-6. https://doi.org/10.1097/SCS.0000000000001495 PMid:25901670

Ogawa K, Takahashi K, Asato Y, Yamamoto Y, Taira K, Matori S, Iraha S, Yagi N, Yogi A, Haranaga S, Fujita J, Uezato H, Murayama S. Treatment and prognosis of angiosarcoma of the scalp and face: a retrospective analysis of 48 patients. Br J Radiol. 2012; 85(1019):e1127-33. https://doi.org/10.1259/bjr/31655219 PMid:22806620 PMCid:PMC3500812

Letsa I, Benson C, Al-Muderis O, Judson I. Angiosarcoma of the face and scalp: effective systemic treatment in the older patient. J Geriatr Oncol. 2014; 5(3):276-80. https://doi.org/10.1016/j.jgo.2014.02.004 PMid:24685486

Judson I, Radford JA, Harris M, Blay JY, van Hoesel Q, le Cesne A, van Oosterom AT, Clemons MJ, Kamby C, Hermans C, Whittaker J, Donato di Paola E, Verweij J, Nielsen S. Randomised phase II trial of pegylated liposomal doxorubicin (DOXIL/CAELYX) versus doxorubicin in the treatment of advanced or metastatic soft tissue sarcoma: a study by the EORTC Soft Tissue and Bone Sarcoma Group. Eur J Cancer. 2001; 37(7):870-7. https://doi.org/10.1016/S0959-8049(01)00050-8

Toma S, Tucci A, Villani G, Carteni G, Spadini N, Palumbo R. Liposomal doxorubicin (Caelyx) in advanced pretreated soft tissue sarcomas: a phase II study of the Italian Sarcoma Group (ISG). Anticancer Res. 2000; 20(1B):485-91.

Wollina U. Liposomal cancer chemotherapy in dermatology: current status and future prospects. Indian J Dermatol. 2004; 49(3):109-116.

Published
2019-08-30
How to Cite
1.
Wollina U, Koch A, Hansel G, Schönlebe J, Lotti T, Vojvodic A. Cutaneous Angiosarcoma of Head and Neck – A Single-Centre Analysis. Open Access Maced J Med Sci [Internet]. 2019Aug.30 [cited 2020Oct.20];7(18):2976-8. Available from: https://www.id-press.eu/mjms/article/view/oamjms.2019.763

Most read articles by the same author(s)

1 2 > >>