血管肉腫の４例 ４症例の治療と予後のまとめ

Abstract

Angiosarcoma of the scalp is a relatively rare disorder in Japan, but the number of patients has been increasing gradually recently. We report 4 cases of angiosarcoma treated by our department between 1989 and 1998.3 men and one women ranged in age from 77 to 82 (mean, 79.2). The lesion was 3×2cm erythema in one case, and erythema with infiltration and bleeding longer than 20 cm in diameter in the other cases of them. The duration between onset and initial visit was under 3 months (mean of 1.5 months). Treatment consisted of a combination of surgery, localized injection of IL-2, intravenous injection of IL-2, intraarterial one-shot injection of IL-2, intraarterial continuous infusion of IL-2, irradiation, LAK, photodynamic therapy. Two of four patients died of angiosarcoma after 7 months and 27 months, the others died of the unrelated disease. The patient with the 3×2cm erythema survived for 27 months, but the mean duration of survival was 16 months. For patients with widespread lesions, we treated to inhibit tumor spread by intraarterial continuous infusion of IL-2, extensive radiation with a wide margin, and tumor resection including the outer layer of the skull and grafting the skin.