Cheng Yung-Sheng, Chen Tim-Mo, Tsai Wen-Chiuan, Huang Tsai-Wang
Division of Thoracic Surgery, Taiwan.
Division of Plastic Surgery, Department of Surgery, Taiwan.
Int J Surg Case Rep. 2017;34:36-39. doi: 10.1016/j.ijscr.2017.02.026. Epub 2017 Feb 20.
Angiosarcoma is a rare malignant neoplasm with poor prognosis. Angiosarcoma of the scalp is frequently recurs locally, and metastasizes early despite various treatments. The common sites of metastatic are lung, liver, and lymph nodes. Pulmonary metastasis with hemoptysis and pneumothorax is rare but threatening.
A 77-year-old male had recurrent angiosarcoma of the scalp even with post operation radiotherapy. At the same time, recurrent pneumothorax was noted, thus he underwent wedge resection of the right upper lobe of the lung plus pleural biopsy. The final pathologic report of cystic lesions showed metastatic Angiosarcoma. He received intravenous paclitaxel and the lung lesions dramatically diminished subsequently.
Pulmonary metastasis from soft tissue sarcoma had fatal complications and poor prognosis. Metastases of AS to the lung have a well-described morphology on CT scan, but appear to be hypometabolic on PET scan and are easily misinterpreted as benign cysts.
Angiosarcoma is a rare but highly vascular invasive endothelial tumor that generally metastasizes to the lung. It could cause repeated hemoptysis pneumothorax and pleural effusion. Preoperative chest CT may be recommended routinely. Aggressive treatment resulted in not only symptoms control but also good prognosis.
血管肉瘤是一种预后较差的罕见恶性肿瘤。头皮血管肉瘤虽经多种治疗仍常局部复发且早期转移。常见转移部位为肺、肝和淋巴结。伴有咯血和气胸的肺转移虽罕见但很危险。
一名77岁男性,即使术后接受放疗,头皮血管肉瘤仍复发。同时,发现反复气胸,因此他接受了右肺上叶楔形切除术加胸膜活检。囊性病变的最终病理报告显示为转移性血管肉瘤。他接受了静脉注射紫杉醇治疗,随后肺部病变显著缩小。
软组织肉瘤的肺转移有致命并发症且预后不良。血管肉瘤肺转移在CT扫描上有明确的形态学表现,但在PET扫描上表现为代谢减低,容易被误诊为良性囊肿。
血管肉瘤是一种罕见但血管侵袭性强的内皮肿瘤,通常转移至肺。它可导致反复咯血、气胸和胸腔积液。建议常规进行术前胸部CT检查。积极治疗不仅能控制症状,而且预后良好。