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Infraorbital cutaneous angiosarcoma: a diagnostic and therapeutic dilemma.

Ettl T, Kleinheinz J, Mehrotra R, Schwarz S, Reichert TE, Driemel O - Head Face Med (2008)

Bottom Line: This case presents a 64-year-old man with a six-month-history of a recurrent diffuse and erythematous painless swelling below the left eye.Neither, finally achieved negative margins on permanent sections, nor a following chemotherapy could prevent the recurrence of the disease after five months and the patient's dead 21 months after the first diagnosis.The case elucidates the current diagnostic and therapeutic dilemma of this entity, which shows an unfavourable clinical course in spite of multimodal therapy.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Oral and Maxillofacial Surgery, Muenster University, Germany. Johannes.Kleinheinz@ukmuenster.de

ABSTRACT

Background: A cutaneous angiosarcoma is a rare malignant tumour of vascular endothelial cells with aggressive clinical behaviour and poor prognosis. Diagnosis is often delayed due to its variable and often benign clinical appearance.

Case presentation: This case presents a 64-year-old man with a six-month-history of a recurrent diffuse and erythematous painless swelling below the left eye. Several resections with intraoperatively negative resection margins followed, but positive margins were repeatedly detected later on permanent sections. Histopathologic examination of the specimen diagnosed a cutaneous angiosarcoma. Neither, finally achieved negative margins on permanent sections, nor a following chemotherapy could prevent the recurrence of the disease after five months and the patient's dead 21 months after the first diagnosis.

Conclusion: The case elucidates the current diagnostic and therapeutic dilemma of this entity, which shows an unfavourable clinical course in spite of multimodal therapy.

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Clinical finding after first surgery: Intraoperative defect, 4 × 2.5 cm2 in size.
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Figure 3: Clinical finding after first surgery: Intraoperative defect, 4 × 2.5 cm2 in size.

Mentions: After referral of the patient to the Department of Oral and Maxillofacial Surgery, Regensburg University, Germany, the tumour was removed by wide local surgical excision (Figure 3) and the defect was temporarily covered by Epigard. Despite negative intraoperative frozen section margins, positive margins were repeatedly detected later on permanent sections. Negative margins on permanent section were finally reached after three resections and infraorbital soft tissue was plastically reconstructed with a buccal rotation flap. After surgery, chemotherapy followed with six cycles of alpha-interferon.


Infraorbital cutaneous angiosarcoma: a diagnostic and therapeutic dilemma.

Ettl T, Kleinheinz J, Mehrotra R, Schwarz S, Reichert TE, Driemel O - Head Face Med (2008)

Clinical finding after first surgery: Intraoperative defect, 4 × 2.5 cm2 in size.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2533304&req=5

Figure 3: Clinical finding after first surgery: Intraoperative defect, 4 × 2.5 cm2 in size.
Mentions: After referral of the patient to the Department of Oral and Maxillofacial Surgery, Regensburg University, Germany, the tumour was removed by wide local surgical excision (Figure 3) and the defect was temporarily covered by Epigard. Despite negative intraoperative frozen section margins, positive margins were repeatedly detected later on permanent sections. Negative margins on permanent section were finally reached after three resections and infraorbital soft tissue was plastically reconstructed with a buccal rotation flap. After surgery, chemotherapy followed with six cycles of alpha-interferon.

Bottom Line: This case presents a 64-year-old man with a six-month-history of a recurrent diffuse and erythematous painless swelling below the left eye.Neither, finally achieved negative margins on permanent sections, nor a following chemotherapy could prevent the recurrence of the disease after five months and the patient's dead 21 months after the first diagnosis.The case elucidates the current diagnostic and therapeutic dilemma of this entity, which shows an unfavourable clinical course in spite of multimodal therapy.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Oral and Maxillofacial Surgery, Muenster University, Germany. Johannes.Kleinheinz@ukmuenster.de

ABSTRACT

Background: A cutaneous angiosarcoma is a rare malignant tumour of vascular endothelial cells with aggressive clinical behaviour and poor prognosis. Diagnosis is often delayed due to its variable and often benign clinical appearance.

Case presentation: This case presents a 64-year-old man with a six-month-history of a recurrent diffuse and erythematous painless swelling below the left eye. Several resections with intraoperatively negative resection margins followed, but positive margins were repeatedly detected later on permanent sections. Histopathologic examination of the specimen diagnosed a cutaneous angiosarcoma. Neither, finally achieved negative margins on permanent sections, nor a following chemotherapy could prevent the recurrence of the disease after five months and the patient's dead 21 months after the first diagnosis.

Conclusion: The case elucidates the current diagnostic and therapeutic dilemma of this entity, which shows an unfavourable clinical course in spite of multimodal therapy.

Show MeSH
Related in: MedlinePlus