A radiation-induced and radiation-sensitive, delayed onset angiosarcoma arising in a precursor lymphangioendothelioma
Identifieur interne : 001F46 ( Pmc/Corpus ); précédent : 001F45; suivant : 001F47A radiation-induced and radiation-sensitive, delayed onset angiosarcoma arising in a precursor lymphangioendothelioma
Auteurs : Michael J. Mckay ; Kirsty Rady ; Timothy M. Mckay ; Jeremy N. MckaySource :
- Annals of Translational Medicine [ 2305-5839 ] ; 2017.
Abstract
An 83-year-old female was treated with mastectomy and postoperative radiotherapy for breast cancer 30 years prior to developing a new small patch of thickening and scaliness on her left upper back, within the previous radiotherapy field. Serial excision biopsies revealed this to be a lymphangioendothelioma with no suggestion of malignancy. In early 2006 the lesion began to enlarge and take on a more erythematous plaque-like appearance. She was reviewed by a specialist dermatologist and an excision biopsy revealed a low-grade cutaneous angiosarcoma; this was approximately 38 years after radiotherapy to this region, the longest reported period between irradiation and in-field angiosarcoma development (the previous being 16 years). To our knowledge, this is the first case of post-radiotherapy angiosarcoma with a diagnosed precursor lesion. The lesion was treated with surgical excision and adjuvant radiotherapy. After further in- and out of- field recurrences, low dose radiotherapy elicited a surprisingly rapid and complete response within the treated areas; this was unusual in that these tumours are characteristically radiation-resistant. The radiosensitive case we report here raises the possibility that radiation should be more widely considered in the therapy of this disease. Methods of treatment of this rare malignancy are discussed.
Url:
DOI: 10.21037/atm.2017.03.19
PubMed: 28462217
PubMed Central: 5395478
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PMC:5395478Le document en format XML
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<author><name sortKey="Mckay, Michael J" sort="Mckay, Michael J" uniqKey="Mckay M" first="Michael J." last="Mckay">Michael J. Mckay</name>
<affiliation><nlm:aff id="aff1">Department of Medicine, University of Sydney, Camperdown, NSW,<country>Australia</country>
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<author><name sortKey="Rady, Kirsty" sort="Rady, Kirsty" uniqKey="Rady K" first="Kirsty" last="Rady">Kirsty Rady</name>
<affiliation><nlm:aff id="aff2">Department of Radiation Oncology, Canberra Hospital and Australian National University, Canberra, ACT,<country>Australia</country>
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<author><name sortKey="Mckay, Timothy M" sort="Mckay, Timothy M" uniqKey="Mckay T" first="Timothy M." last="Mckay">Timothy M. Mckay</name>
<affiliation><nlm:aff id="aff3">Department of Life and Environmental Sciences, Deakin University, Burwood, VIC,<country>Australia</country>
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<author><name sortKey="Mckay, Jeremy N" sort="Mckay, Jeremy N" uniqKey="Mckay J" first="Jeremy N." last="Mckay">Jeremy N. Mckay</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">A radiation-induced and radiation-sensitive, delayed onset angiosarcoma arising in a precursor lymphangioendothelioma</title>
<author><name sortKey="Mckay, Michael J" sort="Mckay, Michael J" uniqKey="Mckay M" first="Michael J." last="Mckay">Michael J. Mckay</name>
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<author><name sortKey="Mckay, Timothy M" sort="Mckay, Timothy M" uniqKey="Mckay T" first="Timothy M." last="Mckay">Timothy M. Mckay</name>
<affiliation><nlm:aff id="aff3">Department of Life and Environmental Sciences, Deakin University, Burwood, VIC,<country>Australia</country>
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<author><name sortKey="Mckay, Jeremy N" sort="Mckay, Jeremy N" uniqKey="Mckay J" first="Jeremy N." last="Mckay">Jeremy N. Mckay</name>
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<series><title level="j">Annals of Translational Medicine</title>
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<front><div type="abstract" xml:lang="en"><p>An 83-year-old female was treated with mastectomy and postoperative radiotherapy for breast cancer 30 years prior to developing a new small patch of thickening and scaliness on her left upper back, within the previous radiotherapy field. Serial excision biopsies revealed this to be a lymphangioendothelioma with no suggestion of malignancy. In early 2006 the lesion began to enlarge and take on a more erythematous plaque-like appearance. She was reviewed by a specialist dermatologist and an excision biopsy revealed a low-grade cutaneous angiosarcoma; this was approximately 38 years after radiotherapy to this region, the longest reported period between irradiation and in-field angiosarcoma development (the previous being 16 years). To our knowledge, this is the first case of post-radiotherapy angiosarcoma with a diagnosed precursor lesion. The lesion was treated with surgical excision and adjuvant radiotherapy. After further in- and out of- field recurrences, low dose radiotherapy elicited a surprisingly rapid and complete response within the treated areas; this was unusual in that these tumours are characteristically radiation-resistant. The radiosensitive case we report here raises the possibility that radiation should be more widely considered in the therapy of this disease. Methods of treatment of this rare malignancy are discussed.</p>
</div>
</front>
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<pmc article-type="case-report"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Ann Transl Med</journal-id>
<journal-id journal-id-type="iso-abbrev">Ann Transl Med</journal-id>
<journal-id journal-id-type="publisher-id">ATM</journal-id>
<journal-title-group><journal-title>Annals of Translational Medicine</journal-title>
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<issn pub-type="ppub">2305-5839</issn>
<issn pub-type="epub">2305-5847</issn>
<publisher><publisher-name>AME Publishing Company</publisher-name>
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<article-meta><article-id pub-id-type="pmid">28462217</article-id>
<article-id pub-id-type="pmc">5395478</article-id>
<article-id pub-id-type="publisher-id">atm-05-06-137</article-id>
<article-id pub-id-type="doi">10.21037/atm.2017.03.19</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Case Report</subject>
</subj-group>
</article-categories>
<title-group><article-title>A radiation-induced and radiation-sensitive, delayed onset angiosarcoma arising in a precursor lymphangioendothelioma</article-title>
</title-group>
<contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>McKay</surname>
<given-names>Michael J.</given-names>
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<xref ref-type="aff" rid="aff1"><sup>1</sup>
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</contrib>
<contrib contrib-type="author"><name><surname>Rady</surname>
<given-names>Kirsty</given-names>
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<xref ref-type="aff" rid="aff2"><sup>2</sup>
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<contrib contrib-type="author"><name><surname>McKay</surname>
<given-names>Timothy M.</given-names>
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<xref ref-type="aff" rid="aff3"><sup>3</sup>
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<contrib contrib-type="author"><name><surname>McKay</surname>
<given-names>Jeremy N.</given-names>
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<xref ref-type="aff" rid="aff4"><sup>4</sup>
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<aff id="aff1"><label>1</label>
Department of Medicine, University of Sydney, Camperdown, NSW,<country>Australia</country>
;</aff>
<aff id="aff2"><label>2</label>
Department of Radiation Oncology, Canberra Hospital and Australian National University, Canberra, ACT,<country>Australia</country>
;</aff>
<aff id="aff3"><label>3</label>
Department of Life and Environmental Sciences, Deakin University, Burwood, VIC,<country>Australia</country>
;</aff>
<aff id="aff4"><label>4</label>
Department of Biological Sciences, Monash University, Clayton, VIC,<country>Australia</country>
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<author-notes><corresp id="cor1"><italic>Correspondence to:</italic>
Prof. Michael J. McKay. Department of Medicine, University of Sydney, Camperdown, 2050 NSW, Australia. Email: <email xlink:href="cohesin@yahoo.com.au">cohesin@yahoo.com.au</email>
.</corresp>
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<pub-date pub-type="epub-ppub"><month>3</month>
<year>2017</year>
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<pmc-comment>Fake ppub date generated by PMC from publisher
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<pub-date pub-type="ppub"><month>3</month>
<year>2017</year>
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<volume>5</volume>
<issue>6</issue>
<elocation-id>137</elocation-id>
<history><date date-type="received"><day>06</day>
<month>2</month>
<year>2017</year>
</date>
<date date-type="accepted"><day>21</day>
<month>2</month>
<year>2017</year>
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<permissions><copyright-statement>2017 Annals of Translational Medicine. All rights reserved.</copyright-statement>
<copyright-year>2017</copyright-year>
<copyright-holder>Annals of Translational Medicine.</copyright-holder>
</permissions>
<abstract><p>An 83-year-old female was treated with mastectomy and postoperative radiotherapy for breast cancer 30 years prior to developing a new small patch of thickening and scaliness on her left upper back, within the previous radiotherapy field. Serial excision biopsies revealed this to be a lymphangioendothelioma with no suggestion of malignancy. In early 2006 the lesion began to enlarge and take on a more erythematous plaque-like appearance. She was reviewed by a specialist dermatologist and an excision biopsy revealed a low-grade cutaneous angiosarcoma; this was approximately 38 years after radiotherapy to this region, the longest reported period between irradiation and in-field angiosarcoma development (the previous being 16 years). To our knowledge, this is the first case of post-radiotherapy angiosarcoma with a diagnosed precursor lesion. The lesion was treated with surgical excision and adjuvant radiotherapy. After further in- and out of- field recurrences, low dose radiotherapy elicited a surprisingly rapid and complete response within the treated areas; this was unusual in that these tumours are characteristically radiation-resistant. The radiosensitive case we report here raises the possibility that radiation should be more widely considered in the therapy of this disease. Methods of treatment of this rare malignancy are discussed.</p>
</abstract>
<kwd-group kwd-group-type="author"><title>Keywords: </title>
<kwd>Chest wall</kwd>
<kwd>angiosarcoma</kwd>
<kwd>lymphangioendothelioma</kwd>
<kwd>radiotherapy</kwd>
</kwd-group>
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