Atypical presentation of angiosarcoma of the scalp in the setting of Human Immunodeficiency Virus (HIV)
Tóm tắt
Angiosarcoma of the head and neck is an uncommon, aggressive malignant entity most commonly found in elderly Caucasian males. We present a case in a young black female with co-existing HIV. The atypical gender, age and race of the patient reflect the unusual clinical presentation of this case of angiosarcoma, attributable to the patient's HIV status. A 22 year old patient presented with a large unresectable lesion over the occiput with surrounding ulceration, satellite lesions and associated lymphadenopathy. She is HIV-infected with a CD4 count of 360 cells/μl. She was not on antiretroviral treatment based on South African treatment guidelines advocating antiretroviral treatment when the CD4 count is below 200 cells/μl, in the absence of other AIDS-defining illnesses. The patient was treated with a course of ifosfamide and anthracyline based chemotherapy. Disease progression was noted on chemotherapy and she was subsequently palliated with a course of radiotherapy. She had a satisfactory response with an improvement in local symptoms. She is currently receiving symptomatic care. South Africa is at the epicenter of the HIV epidemic. Consequently, the management of patients in the field of oncology in our clinical practice is often burdened with malignancies manifesting with an atypical disease presentation and clinical course.
Tài liệu tham khảo
Holloway CL, Turner AR, Dundas GS: Cutaneous angiosarcoma of the scalp: A case report of sustained complete response following liposomal doxorubicin and radiation therapy. Sarcoma. 2005, 9 (1/2): 29-31. 10.1080/13577140500043948.
Rajinikanth J, Gaikwad P, Raj JP, Tirkey AJ, Muthusami JC: Angiosarcoma of the scalp. Otolaryngol-Head and Neck Surg. 2008, 138: 255-256. 10.1016/j.otohns.2007.11.007.
Obeng MK, Hernandez A, Dastgir A, Adegboyega PA, Salinas P, Gore DC: Angiosarcoma of the scalp with calvarium involvement in a 50 year old African-American man. J Natl Med Assoc. 2004, 96 (11): 1507-1512.
Pantanowitz L, Schlecht HP, Dezube BJ: The growing problems of non-AIDS-defining malignancies in HIV. Curr Opin Oncol. 2006, 18: 469-478. 10.1097/01.cco.0000239886.13537.ed.
'Mid-year population estimates 2009'. [http://www.statssa.gov.za/PublicationsHTML/P03022009/html/P03022009.html]
Köhler HF, Neves RI, Brechtbühl ER, Granja NVM, Ikeda MK, Kowalski LP: Cutaneous angiosarcoma of the head and neck: Report of 23 cases from a single institution. Otolaryngol-Head and Neck Surg. 2008, 139: 519-524. 10.1016/j.otohns.2008.07.022.
Lankester KJ, Brown RSD, Spittle MF: Complete resolution of angiosarcoma of the scalp with liposomal daunorubicin and radiotherapy. Clin Oncol (R Coll Radiol). 1991, 11: 208-210.
Fedok FG, Levin RJ, Maloney ME, Tipirneni K: Angiosarcoma: Current Review. Am J Otolaryngol. 1999, 20 (4): 223-231. 10.1016/S0196-0709(99)90004-2.
Ohguri T, Imada H, Nomoto S, Yahara K, Hisaoka M, Hashimoto H, Tokura Y, Nakamura K, Shioyama Y, Honda H, Terashima H, Moroi Y, Furue M, Korogi Y: Angiosarcoma of the scalp treated with recombinant Interleukin-2 immunotherapy. Int J Radiat Oncol Biol Phys. 2005, 61 (5): 1446-1453.
Schlemmer M, Reichardt P, Verweij J, Hartmann JT, Judson I, Thyss A, Hogendoorn PCW, Marreaud S, Van Glabbeke M, Blay JY: Paclitaxel in patients with advanced angiosarcomas of soft tissue: A retrospective study of the EORTC soft tissue and bone sarcoma group. Eur J Cancer. 2008, 44: 2433-2436. 10.1016/j.ejca.2008.07.037.