Angiosarcoma: a case report of gingival disease with both palatine tonsils localization
Angiosarcomas are one of the rarest subtypes of sarcomas; those are malignant vascular tumors arising from vascular endothelial cells. Occurrence of intra-oral angiosarcoma is extremely rare (0.0077% of all cancers in Europe). We present here, to our knowledge, the first case of a 83-year-old man wi...
Main Authors: | , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
SAGE Publishing
2016-10-01
|
Series: | Rare Tumors |
Subjects: | |
Online Access: | http://www.pagepress.org/journals/index.php/rt/article/view/5907 |
id |
doaj-12dd38f32a9b4ec7abc38d269bbd1025 |
---|---|
record_format |
Article |
spelling |
doaj-12dd38f32a9b4ec7abc38d269bbd10252020-11-25T03:34:53ZengSAGE PublishingRare Tumors2036-36052036-36132016-10-018310.4081/rt.2016.59073546Angiosarcoma: a case report of gingival disease with both palatine tonsils localizationFrédéric Chamberland0Tristan Maurina1Séverine Degano-Valmary2Thierry Spicarolen3Loïc Chaigneau4Department of Otorhinolaryngology and Head and Neck Surgery, Hospital Nord Franche-Comté, BelfortDepartment of Oncology, University Hospital Center Jean Minjoz, BesançonDepartment of Pathology, University Hospital Center Jean Minjoz, BesançonDepartment of Otorhinolaryngology and Head and Neck Surgery, Hospital Nord Franche-Comté, BelfortDepartment of Oncology, University Hospital Center Jean Minjoz, BesançonAngiosarcomas are one of the rarest subtypes of sarcomas; those are malignant vascular tumors arising from vascular endothelial cells. Occurrence of intra-oral angiosarcoma is extremely rare (0.0077% of all cancers in Europe). We present here, to our knowledge, the first case of a 83-year-old man with gingival and both palatine tonsils localization of a grade-two angiosarcoma discovered after a two months history of a painful lesion followed by hematoma and spontaneous bleeding. Chemotherapy with paclitaxel and hemostatic radiotherapy were inefficient and he died seven months after the first symptoms. It is essential to use the vascular markers, such as CD34, CD31, ERG and FLI1, for a correct histological diagnosis, which remains difficult because it displays a wide range of morphological appearances and multiple patterns may be present in the same tumor. The main prognostic factors are chronic pre-existing lymphedema and tumor size greater than five centimeters. Malignancy grade and stage classification should be provided in all cases in which this is feasible because of predictive meaning. When possible, wide surgical resection with negative margins remains the cornerstone for the treatment of localized angiosarcomas, but despite the improvement of surgical techniques the prognosis is poor with more than half of patients died within the first year. Adjuvant radiotherapy is the standard treatment of high–grade (two and three), deep lesions, regardless of size, because it improved the local recurrence-free survival. For advanced disease, if possible, metastasectomy should be considered. The first-line chemotherapy with doxorubicin or paclitaxel should be discussed compared to best supportive care according to patient comorbidities and preference.http://www.pagepress.org/journals/index.php/rt/article/view/5907Angiosarcomahead and neckgingivapalatine tonsil |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Frédéric Chamberland Tristan Maurina Séverine Degano-Valmary Thierry Spicarolen Loïc Chaigneau |
spellingShingle |
Frédéric Chamberland Tristan Maurina Séverine Degano-Valmary Thierry Spicarolen Loïc Chaigneau Angiosarcoma: a case report of gingival disease with both palatine tonsils localization Rare Tumors Angiosarcoma head and neck gingiva palatine tonsil |
author_facet |
Frédéric Chamberland Tristan Maurina Séverine Degano-Valmary Thierry Spicarolen Loïc Chaigneau |
author_sort |
Frédéric Chamberland |
title |
Angiosarcoma: a case report of gingival disease with both palatine tonsils localization |
title_short |
Angiosarcoma: a case report of gingival disease with both palatine tonsils localization |
title_full |
Angiosarcoma: a case report of gingival disease with both palatine tonsils localization |
title_fullStr |
Angiosarcoma: a case report of gingival disease with both palatine tonsils localization |
title_full_unstemmed |
Angiosarcoma: a case report of gingival disease with both palatine tonsils localization |
title_sort |
angiosarcoma: a case report of gingival disease with both palatine tonsils localization |
publisher |
SAGE Publishing |
series |
Rare Tumors |
issn |
2036-3605 2036-3613 |
publishDate |
2016-10-01 |
description |
Angiosarcomas are one of the rarest subtypes of sarcomas; those are malignant vascular tumors arising from vascular endothelial cells. Occurrence of intra-oral angiosarcoma is extremely rare (0.0077% of all cancers in Europe). We present here, to our knowledge, the first case of a 83-year-old man with gingival and both palatine tonsils localization of a grade-two angiosarcoma discovered after a two months history of a painful lesion followed by hematoma and spontaneous bleeding. Chemotherapy with paclitaxel and hemostatic radiotherapy were inefficient and he died seven months after the first symptoms. It is essential to use the vascular markers, such as CD34, CD31, ERG and FLI1, for a correct histological diagnosis, which remains difficult because it displays a wide range of morphological appearances and multiple patterns may be present in the same tumor. The main prognostic factors are chronic pre-existing lymphedema and tumor size greater than five centimeters. Malignancy grade and stage classification should be provided in all cases in which this is feasible because of predictive meaning. When possible, wide surgical resection with negative margins remains the cornerstone for the treatment of localized angiosarcomas, but despite the improvement of surgical techniques the prognosis is poor with more than half of patients died within the first year. Adjuvant radiotherapy is the standard treatment of high–grade (two and three), deep lesions, regardless of size, because it improved the local recurrence-free survival. For advanced disease, if possible, metastasectomy should be considered. The first-line chemotherapy with doxorubicin or paclitaxel should be discussed compared to best supportive care according to patient comorbidities and preference. |
topic |
Angiosarcoma head and neck gingiva palatine tonsil |
url |
http://www.pagepress.org/journals/index.php/rt/article/view/5907 |
work_keys_str_mv |
AT fredericchamberland angiosarcomaacasereportofgingivaldiseasewithbothpalatinetonsilslocalization AT tristanmaurina angiosarcomaacasereportofgingivaldiseasewithbothpalatinetonsilslocalization AT severinedeganovalmary angiosarcomaacasereportofgingivaldiseasewithbothpalatinetonsilslocalization AT thierryspicarolen angiosarcomaacasereportofgingivaldiseasewithbothpalatinetonsilslocalization AT loicchaigneau angiosarcomaacasereportofgingivaldiseasewithbothpalatinetonsilslocalization |
_version_ |
1724556868357980160 |