Wollina Uwe, Koch André, Hansel Gesina, Schönlebe Jacqueline, Lotti Torello, Vojvodic Aleksandra
Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Academic Teaching Hospital, Dresden, Germany.
Institute of Pathology "Georg Schmorl", Städtisches Klinikum Dresden, Academic Teaching Hospital, Dresden, Germany.
Open Access Maced J Med Sci. 2019 Aug 30;7(18):2976-2978. doi: 10.3889/oamjms.2019.763. eCollection 2019 Sep 30.
Cutaneous angiosarcoma of the head and neck region is a subtype of cutaneous angiosarcoma with an unfavourable prognosis. Diagnosis is often delayed.
The setting is an Academic Teaching Hospital Skin Cancer Center. Eight Caucasian patients could be identified, 5 men and 3 women. Delay to diagnosis was between 12 to 4 months (mean 7.8 ± 2.9 months). The diagnosis was confirmed in all cases by histopathology and immunohistochemistry. Hematoxylin-eosin, Giemsa, PAS, iron and reticulin stains were performed. Endothelial markers such as CD31, CD34, and Ki67 for proliferation assessment were used in all tumours. Other markers used included pan-cytokeratin (CK), CK7, CK20, ERG, CD 40 and c-MYC. Tumours were classified as localised versus multifocal or diffuse form. Tumour staging was performed according to the 8th edition of the AJCC. The mean age of patients was 79 years ± 26.4 years. The male to female ratio was 1.7. Tumour classification was diffuse in 2 patients, multilocular in one and localised in 5 patients. In 5 of 8 patients, a multimodal treatment was performed, one had radiotherapy alone, in another patient surgery was performed, and radiotherapy is planned. The mean OS was 26.4 months ± 24.5 months.
Cutaneous angiosarcoma of the head and neck is an aggressive tumour with a poor prognosis. Although surgery remains a cornerstone of treatment, the tumour size at first presentation may be too large, and the elderly patients maybe not suitable for extensive surgery. Therefore, multimodal treatment with adjuvant radiotherapy and/ or chemotherapy is necessary. Multimodal treatment offers a better outcome than radiotherapy or chemotherapy alone. Stealth liposomal encapsulated doxorubicin is a therapeutic option for elderly patients with improved safety compared to conventional doxorubicin.
头颈部皮肤血管肉瘤是皮肤血管肉瘤的一种亚型，预后不良。诊断往往延迟。
研究地点为一所学术教学医院的皮肤癌中心。共确定了8名白种人患者，5名男性和3名女性。诊断延迟时间为12至4个月（平均7.8±2.9个月）。所有病例均通过组织病理学和免疫组织化学确诊。进行了苏木精-伊红染色、吉姆萨染色、PAS染色、铁染色和网状纤维染色。所有肿瘤均使用内皮标志物如CD31、CD34和用于增殖评估的Ki67。使用的其他标志物包括全细胞角蛋白（CK）、CK7、CK20、ERG、CD40和c-MYC。肿瘤分为局限性、多灶性或弥漫性。根据美国癌症联合委员会第8版进行肿瘤分期。患者的平均年龄为79岁±26.4岁。男女比例为1.7。2例患者的肿瘤分类为弥漫性，1例为多房性，5例为局限性。8例患者中有5例接受了多模式治疗，1例仅接受了放疗，另1例患者接受了手术治疗，并计划进行放疗。平均总生存期为26.4个月±24.5个月。
头颈部皮肤血管肉瘤是一种侵袭性肿瘤，预后较差。尽管手术仍然是治疗的基石，但首次就诊时肿瘤大小可能过大，老年患者可能不适合进行广泛手术。因此，辅助放疗和/或化疗的多模式治疗是必要的。多模式治疗比单独放疗或化疗能带来更好的结果。与传统阿霉素相比，隐形脂质体包裹阿霉素对老年患者是一种安全性更高的治疗选择。
