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皮肤血管肉瘤:一例报告。

Cutaneous angiosarcoma: A case report.

作者信息

Oley Maximillian Christian, Oley Mendy Hatibie, Durry Meilany Feronika, Kepel Regina Elizabeth Meriam, Faruk Muhammad

机构信息

Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Sam Ratulangi University, Manado, Indonesia; Division of Neurosurgery, Department of Surgery, R. D. Kandou Hospital, Manado, Indonesia.

Division of Plastic Reconstructive & Aesthetic Surgery, Department of Surgery, Faculty of Medicine, Sam Ratulangi University, Manado, Indonesia; Division of Plastic Reconstructive & Aesthetic Surgery, Department of Surgery, R. D. Kandou Hospital, Manado, Indonesia; Craniofacial and Cleft Center, Siloam Hospital, Manado, Indonesia.

出版信息

Int J Surg Case Rep. 2021 Nov;88:106506. doi: 10.1016/j.ijscr.2021.106506. Epub 2021 Oct 14.

Abstract

INTRODUCTION

Angiosarcoma is a very rare malignancy, which varies based on the location and organ affected. A clinicopathological form of cutaneous angiosarcoma (CAS) involves the head: scalp, face, and neck. We report a 59-year-old female patient with CAS on the temporoparietal region of the scalp.

CASE PRESENTATION

The patient presented with lesions in the head area, which appeared suddenly in the last 6 months, (before her surgery). Excision was performed under general anesthesia for bleeding as indicated on the right temporal region. The excision procedure was carried out three times at various stages, and then closed with skin grafts. Pathological examination of the three excised tissues showed progression, leading to CAS. Based on the clinical picture and anatomical assessment, a consultation with the surgical oncology department was necessary for further treatment.

DISCUSSION

Angiosarcoma has a high rate of progression. The onset of lesions, which are difficult to detect, does not often lead to progression. Other macroscopic features appear as bluish macules, which can be perceived as bruising. Wide surgical resection is the optimal treatment and is usually combined with radiotherapy and/or chemotherapy. This patient underwent gradual excision, based on bleeding in the right temporal lesion, along with progressive pain.

CONCLUSION

Surgical is the preferred management for our patients. Determination of multimodality therapy as treatment for CAS requires assessment of all factors related to age and patient condition. Follow-up evaluation is carried out after palliative therapy - to observe the general condition of the patient, tumor progression, tendency for metastases, and excision of any remaining lesions.

摘要

引言

血管肉瘤是一种非常罕见的恶性肿瘤,其表现因受累的部位和器官而异。皮肤血管肉瘤(CAS)的一种临床病理形式累及头部:头皮、面部和颈部。我们报告一名59岁女性患者,其头皮颞顶区域患有CAS。

病例介绍

患者头部出现病变,在过去6个月(手术前)突然出现。因右侧颞部区域有出血迹象,在全身麻醉下进行了切除。切除过程在不同阶段进行了三次,然后用皮肤移植进行缝合。对三次切除组织的病理检查显示病情进展,最终确诊为CAS。根据临床表现和解剖学评估,有必要咨询外科肿瘤科进行进一步治疗。

讨论

血管肉瘤进展率高。病变开始时难以察觉,通常不会导致病情进展。其他肉眼可见的特征表现为蓝色斑疹,可被视为瘀伤。广泛的手术切除是最佳治疗方法,通常与放疗和/或化疗联合使用。该患者基于右侧颞部病变出血以及进行性疼痛,接受了逐步切除。

结论

手术是我们患者的首选治疗方法。确定多模态治疗作为CAS的治疗方案需要评估与年龄和患者状况相关的所有因素。在姑息治疗后进行随访评估——观察患者的一般状况、肿瘤进展、转移倾向以及切除任何残留病变。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aeef/8577069/5842115f2b0d/gr1.jpg

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