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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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Related in: MedlinePlus

MRI (axial): Left infraorbital mass with infiltration to the lateral nasal root.
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Figure 5: MRI (axial): Left infraorbital mass with infiltration to the lateral nasal root.

Mentions: Five months later a periorbital redness and swelling on both sides (Figure 4) required another incisional biopsy, which was confirmed as recurrent angiosarcoma on histopathological examination. Imaging staging procedures (MRI and CT head-neck, CT chest, CT abdomen, PET and bone scan) found bone invasion to the nasal root (Figure 5). Metastases to the neck lymph nodes as well as distant metastases were clinically and radiologically excluded.


Infraorbital cutaneous angiosarcoma: a diagnostic and therapeutic dilemma.

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

MRI (axial): Left infraorbital mass with infiltration to the lateral nasal root.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 5: MRI (axial): Left infraorbital mass with infiltration to the lateral nasal root.
Mentions: Five months later a periorbital redness and swelling on both sides (Figure 4) required another incisional biopsy, which was confirmed as recurrent angiosarcoma on histopathological examination. Imaging staging procedures (MRI and CT head-neck, CT chest, CT abdomen, PET and bone scan) found bone invasion to the nasal root (Figure 5). Metastases to the neck lymph nodes as well as distant metastases were clinically and radiologically excluded.

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