Abstract
Angiosarcoma of the face and neck is a rare soft tissue sarcoma with a high degree of malignancy. The current treatment methods mainly rely on a combination of surgery and radiotherapy and/or chemotherapy. However, the options for drug treatment are very limited and surgery can be difficult to carry out due to the location of the tumor, so the efficacy of first-line drugs needs to be constantly explored. A case of angiosarcoma of the head and face diagnosed by biopsy is reported here. The patient received an oral anlotinib hydrochloride capsule once a day (12 mg on days 1 - 14/1 week off for a 21-day cycle) due to the difficulty of surgery. Until now (April, 2020), after 10 months of treatment, the patient’s scalp and facial lesions have gradually reduced and the partial response and progression-free survival of this patient were good, with moderate or tolerable adverse events. This approach provides a new approach for the clinical treatment of malignant angiosarcoma of the face and neck with anlotinib as first-line therapy.
Highlights
Angiosarcoma (AS) is a rare soft tissue sarcoma (STS) that arises from the endothelial cells of blood vessels or the lymphatics and accounts for about 2% of all soft tissue sarcomas [1,2,3,4]
The diagnosis results were as follows: 1) Ischemia foci in the bilateral hemi oval center and frontal parietal lobe; 2) Demyelinating changes of white matter and brain atrophy; and 3) Soft tissue swelling at the top of the head with visible enhancement. All these AS related findings indicated the efficacy of anlotinib as first-line treatment, but more observations will be necessary before reaching a definitive conclusion
The results showed that the scalp and facial lesions were gradually controlled and evaluated as partial response (PR), with a Progression-free survival (PFS) of 10 months up to now
Summary
Angiosarcoma (AS) is a rare soft tissue sarcoma (STS) that arises from the endothelial cells of blood vessels or the lymphatics and accounts for about 2% of all soft tissue sarcomas [1,2,3,4]. A chest CT revealed a low number of fiber proliferation foci scattered in the right lung; local thickening and adhesion of the bilateral pleura; right diaphragmatic surface swelling; aortic sclerosis; possible cysts in the left lobe of the liver and right kidney; gallbladder stones; bone hyperplasia of the thoracic vertebra and compressibility changes in the lumbar vertebra (Figures 3A, B). The diagnosis results were as follows: 1) Ischemia foci in the bilateral hemi oval center and frontal parietal lobe; 2) Demyelinating changes of white matter and brain atrophy; and 3) Soft tissue swelling at the top of the head with visible enhancement All these AS related findings indicated the efficacy of anlotinib as first-line treatment, but more observations will be necessary before reaching a definitive conclusion. The current treatment efficacy was evaluated as a partial response (PR) according to the Response Evaluation Criteria in Solid Tumors (RECIST 1.1), since more than a 30% decrease in the sum of the longest diameters of the target lesions compared to
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