Department of Oral and Maxillofacial Surgery, University of Tsukuba, Tsukuba City, Japan.
Int J Oral Sci. 2012 Sep;4(3):166-9. doi: 10.1038/ijos.2012.36. Epub 2012 Jun 15.
Angiosarcoma is an uncommon malignancy, which spread out from the endothelial cells of vessels. Scalp angiosarcoma with cervical lymph node metastasis is particularly rare. This article describes a rare case of angiosarcoma of the scalp, presenting as neck inflammation. Imaging procedures such as computed tomography (CT), magnetic resonance image (MRI) and ultrasonography (US) were not sufficient to diagnose this case. A needle biopsy provided an effective and accurate diagnosis of cervical lymph node metastasis. Additional observation and physical examination was required to diagnose the origin of the primary cancerous lesion. Once the angiosarcoma diagnosis was confirmed histologically, sequential weekly and monthly docetaxel (DTX) treatment was effective in preventing reoccurrence. Nonetheless, the optimization of angiosarcoma treatment remains a future goal. Although patients generally describe pain and swelling at the primary lesion site, this patient complained only of painful neck inflammation, without any indication of pain or swelling of the scalp. A revised diagnostic protocol should note that cervical lymph node metastasis of unknown primary origin may result from angiosarcoma of the scalp.
血管肉瘤是一种罕见的恶性肿瘤,起源于血管内皮细胞。头皮血管肉瘤伴颈部淋巴结转移更为罕见。本文描述了 1 例以颈部炎症为表现的头皮血管肉瘤,罕见病例。CT、MRI 和超声等影像学检查不足以诊断该病例。细针穿刺活检为颈部淋巴结转移提供了有效且准确的诊断。需要进一步观察和体检以明确原发性癌灶的来源。一旦组织学上确诊为血管肉瘤,序贯每周和每月的多西紫杉醇(DTX)治疗可有效预防复发。然而,血管肉瘤治疗的优化仍是未来的目标。尽管患者通常会描述原发性病变部位的疼痛和肿胀,但该患者仅主诉颈部炎症疼痛,头皮无疼痛或肿胀的迹象。修订后的诊断方案应注意到,不明原发灶的颈部淋巴结转移可能是由头皮血管肉瘤引起的。