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Atypical presentation of angiosarcoma of the scalp in the setting of human immunodeficiency virus (HIV).

Govender PS - World J Surg Oncol (2009)

Bottom Line: A 22 year old patient presented with a large unresectable lesion over the occiput with surrounding ulceration, satellite lesions and associated lymphadenopathy.South Africa is at the epicenter of the HIV epidemic.Consequently, the management of patients in the field of oncology in our clinical practice is often burdened with malignancies manifesting with an atypical disease presentation and clinical course.

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Affiliation: Department of Radiotherapy and Oncology, Nelson R, Mandela School of Medicine, University of Kwazulu Natal, Durban, South Africa. poovan.gov@gmail.com

ABSTRACT

Background: Angiosarcoma of the head and neck is an uncommon, aggressive malignant entity most commonly found in elderly Caucasian males. We present a case in a young black female with co-existing HIV. The atypical gender, age and race of the patient reflect the unusual clinical presentation of this case of angiosarcoma, attributable to the patient's HIV status.

Case presentation: A 22 year old patient presented with a large unresectable lesion over the occiput with surrounding ulceration, satellite lesions and associated lymphadenopathy. She is HIV-infected with a CD4 count of 360 cells/microl. She was not on antiretroviral treatment based on South African treatment guidelines advocating antiretroviral treatment when the CD4 count is below 200 cells/microl, in the absence of other AIDS-defining illnesses.The patient was treated with a course of ifosfamide and anthracyline based chemotherapy. Disease progression was noted on chemotherapy and she was subsequently palliated with a course of radiotherapy. She had a satisfactory response with an improvement in local symptoms. She is currently receiving symptomatic care.

Conclusions: South Africa is at the epicenter of the HIV epidemic. Consequently, the management of patients in the field of oncology in our clinical practice is often burdened with malignancies manifesting with an atypical disease presentation and clinical course.

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Enhancing mass lesion in occiput on axial and saggital CT slices.
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Figure 2: Enhancing mass lesion in occiput on axial and saggital CT slices.

Mentions: Computed Tomography (CT) scan revealed a large heterogeneously enhancing soft tissue mass over the scalp in the occipital region with erosion of the underlying bone. Extensive subcentimetre enhancing lymphadenopathy was noted in the anterior and posterior triangles of the neck with the largest noted in the right parotid region measuring 1.1 cm. No distant metastases were noted (Figure 2).


Atypical presentation of angiosarcoma of the scalp in the setting of human immunodeficiency virus (HIV).

Govender PS - World J Surg Oncol (2009)

Enhancing mass lesion in occiput on axial and saggital CT slices.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2803177&req=5

Figure 2: Enhancing mass lesion in occiput on axial and saggital CT slices.
Mentions: Computed Tomography (CT) scan revealed a large heterogeneously enhancing soft tissue mass over the scalp in the occipital region with erosion of the underlying bone. Extensive subcentimetre enhancing lymphadenopathy was noted in the anterior and posterior triangles of the neck with the largest noted in the right parotid region measuring 1.1 cm. No distant metastases were noted (Figure 2).

Bottom Line: A 22 year old patient presented with a large unresectable lesion over the occiput with surrounding ulceration, satellite lesions and associated lymphadenopathy.South Africa is at the epicenter of the HIV epidemic.Consequently, the management of patients in the field of oncology in our clinical practice is often burdened with malignancies manifesting with an atypical disease presentation and clinical course.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Radiotherapy and Oncology, Nelson R, Mandela School of Medicine, University of Kwazulu Natal, Durban, South Africa. poovan.gov@gmail.com

ABSTRACT

Background: Angiosarcoma of the head and neck is an uncommon, aggressive malignant entity most commonly found in elderly Caucasian males. We present a case in a young black female with co-existing HIV. The atypical gender, age and race of the patient reflect the unusual clinical presentation of this case of angiosarcoma, attributable to the patient's HIV status.

Case presentation: A 22 year old patient presented with a large unresectable lesion over the occiput with surrounding ulceration, satellite lesions and associated lymphadenopathy. She is HIV-infected with a CD4 count of 360 cells/microl. She was not on antiretroviral treatment based on South African treatment guidelines advocating antiretroviral treatment when the CD4 count is below 200 cells/microl, in the absence of other AIDS-defining illnesses.The patient was treated with a course of ifosfamide and anthracyline based chemotherapy. Disease progression was noted on chemotherapy and she was subsequently palliated with a course of radiotherapy. She had a satisfactory response with an improvement in local symptoms. She is currently receiving symptomatic care.

Conclusions: South Africa is at the epicenter of the HIV epidemic. Consequently, the management of patients in the field of oncology in our clinical practice is often burdened with malignancies manifesting with an atypical disease presentation and clinical course.

Show MeSH
Related in: MedlinePlus