Angiosarcoma secondary to postirradiation and chronic lymphedema Case reports

Introduction: Angiosarcoma secondary to post-irradiation and lymphedema is rare, but it is aggressive with a poor prognosis. It is essential to understand these patients' clinical features and distinguish them from benign diseases or other malignant tumors. Patient concerns: Three patients who had radiotherapy for cancer treatment and chronic lymphedema admitted to the hospital with specific skin lesions at upper or lower extremities. Diagnosis: Excisional biopsies revealed prominent, highly atypical cells with a vasoformative area, composed of atypical, large epithelioid cells with vesicular nuclei, prominent nucleoli, and mitoses. Immunohistochemistry revealed diffuse expression of endothelial cell markers suggestive of angiosarcoma. Interventions: One patient had shoulder disarticulation with wide excision with adjuvant radiotherapy and chemotherapy and other 2 discontinued the treatment. Outcomes: After the treatment, one patient was transferred to rehabilitation department for shoulder disarticulation prosthesis fitting without recurrence sign for 1 year. Two patient refused further treatment and was lost to follow-up. Conclusion: In cases of patients with irratiation and chronic lymphedema, clinical findings suggestive of angiosarcoma, biopsy and imaging studies should be performed as soon as possible.

Automated summary

The article reported three cases of angiosarcoma secondary to post-irradiation and lymphedema. One patient underwent surgery with a good outcome, while the other two refused treatment. It is important to perform biopsy and imaging studies promptly for patients with clinical findings suggestive of angiosarcoma in the setting of radiation and chronic lymphedema.