Department of Radiotherapy and Oncology, Nelson R, Mandela School of Medicine, University of Kwazulu Natal, Durban, South Africa.
World J Surg Oncol. 2009 Dec 18;7:99. doi: 10.1186/1477-7819-7-99.
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.
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.
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.
头颈部血管肉瘤是一种罕见的侵袭性恶性肿瘤，多见于老年白人男性。我们报告了一例合并 HIV 的年轻黑人女性病例。患者的性别、年龄和种族不典型，反映了该例血管肉瘤的不寻常临床表现，这归因于患者的 HIV 感染状态。
一名 22 岁患者，枕部出现大面积不可切除病变，伴周围溃疡、卫星病变和相关淋巴结病。她感染了 HIV，CD4 计数为 360 个细胞/微升。根据南非治疗指南，她并未接受抗逆转录病毒治疗，该指南主张在 CD4 计数低于 200 个细胞/微升时，在没有其他艾滋病定义性疾病的情况下，开始抗逆转录病毒治疗。患者接受了 IFOS 和蒽环类药物为基础的化疗。化疗期间发现疾病进展，随后给予放疗姑息治疗。她对治疗有满意的反应，局部症状得到改善。目前她正在接受对症治疗。
南非处于 HIV 流行的中心。因此，在我们的临床实践中，肿瘤学领域的患者管理常常受到表现出不典型疾病表现和临床过程的恶性肿瘤的困扰。
