Cutaneous angiosarcoma: update on biology and latest treatment
Purpose of review The present review aims to provide readers with the latest updates on the biology and clinical management of cutaneous angiosarcoma (cAS). Recent findings The genomic alteration of cAS is heterogeneous. Mutations are enriched in the mitosis-activated kinase (MAPK) pathway. Functional analysis has identified molecules that may serve as potential markers and therapeutic targets of angiosarcoma. These molecules include survivin, HSP90, FOXM1, miR-497-5p, KCa3.1, and miR210. This body of knowledge has not yet transferred to clinical practice. The mainstay of treatment for cAS remains surgery followed by postoperative radiotherapy. The efficacy of paclitaxel as an adjuvant chemotherapy is suggested. For patients with advanced cAS, paclitaxel is the treatment of choice. There are also second-line treatment options that are supported by evidence of varying strength. A multikinase inhibitor, pazopanib, has been assessed in several studies, most of which support its efficacy for angiosarcoma. Bevacizumab monotherapy may be effective for angiosarcoma. The efficacy of eribulin mesylate and trabectedin for angiosarcoma is currently being assessed. Recent publications highlighted the role of the immune system in the biology of cAS. Summary Future research efforts should focus on the following aspects of cAS: drug development directed at recent molecular targets, clinical trials designed specifically for patients with cAS, and the role of immunotherapy for cAS.
ConclusionsThe recognition of dermoscopic patterns of cutaneous metastasis of breast cancer is not only useful to facilitate diagnosis at an early stage and to rule out other differentials, especially in difficult presentations such as cellulitis-like lesions or lymphedema, but it may also be used by physicians in monitoring mastectomy scars.
A 76-year-old white man was referred for a nodular lesion in the right hard palate noticed about 8 months prior to presentation. The lesion caused difficulty in fitting complete dentures, and an ulcerated surface caused intense bleeding after removal of the prosthesis. Intraoral examination revealed a black, 3 × 2 cm wide nodule exhibiting purple-colored bleeding areas, pedunculated and with well-defined borders and a lobulated surface. The differential diagnosis included angiosarcoma and melanoma.
Conclusions: Cardiac angiosarcoma had high FDG uptake, which may be due to its poor differentiation and biological behaviors of the tumor cells. The FDG PET/CT scan can detect the primary tumor extension, metastases at diagnosis, postsurgical residue and/or relapse and metastases. But successful diagnosis in this rare case relied on the comprehensive utilization of multimodality imaging techniques.
Conclusion The patient-based sensitivity, specificity and accuracy of WB MRI including DWI were comparable with those of PET/MRI. On the other hand, the lesion-based sensitivities of WB MRI were relatively low, mainly because of the low detectability of small lymph node metastasis. The combination of T2WI and DWI showed acceptable detectability; however, the T1WI sequence showed no additional value to detect malignant lesions on both lesion- and patient-based sensitivities.
Angiosarcoma is a rare malignant tumor of vascular origin that represents 2% of all soft-tissue sarcomas. This highly aggressive tumor spreads widely through the skin, recurs locally and metastasis early. Sonodynamic therapy (SDT) with low-intensity ultrasound combined with a sonosensitizer may be a promising approach to cancer therapy. Sonosensitizers are known as 5-Aminolevulinic acid (5-ALA), bleomycin and photofrin, and others. The protocol of SDT has not been established. We investigated the feasibility of SDT for angiosarcoma with 5-ALA, a precursor of protoporphyrin IX in heme synthetic process.
This study aimed at clarifying the effect of FGF1 signaling on the malignancy of murine angiosarcoma cell line ISOS-1. Highly stable FGF1 mutants were developed previously to increase mitogenic activity more than wild-type FGF1, so ISOS-1 cells were cultured in complete DMEM medium with each FGF1 mutant to examine their effects in the proliferation, migration, and invasion of ISOS-1 cells.
Conclusions. Use of dermal substitutes in oncology can be an option for reconstruction after extended resections, providing good aesthetical and functional results. PMID: 28751990 [PubMed - in process]
ConclusionsAlthough occasional responses to immunotherapy have been reported for sarcomas, this case report demonstrates that angiosarcoma can express PD-L1 and have a sustained response to PD-1 directed therapy.
We report a case of a cutaneous angiosarcoma with strong positivity for tyrosinase, the first to our knowledge, initially misdiagnosed as melanoma. We subsequently evaluated the reactivity of panmelanocytic cocktail (tyrosinase, HMB‐45 and melan‐A), SOX10, tyrosinase and MITF in a large tissue microarray (TMA) of angiosarcoma. The TMA included 142 cases of angiosarcomas (29 cutaneous, 22 primary breast, 41 post‐radiation breast, 15 visceral, 26 deep soft tissue and bone, 5 chronic lymphedema‐associated and 4 angiosarcomas arising in other sarcomas). Immunohistochemical studies were performed with anti‐panmelanocy...
Summary Cutaneous sarcomas comprise a heterogeneous group of mesenchymal spindle cell tumors of the dermis and subcutis, one of the best‐known entities being dermatofibrosarcoma protuberans. Other sarcomas addressed in this review include atypical fibroxanthoma, cutaneous undifferentiated pleomorphic sarcoma, leiomyosarcoma, liposarcoma, and angiosarcoma. With the exception of dermatofibrosarcoma protuberans, which has its peak incidence in middle‐aged adults, cutaneous sarcomas usually occur in elderly individuals starting in the sixth or seventh decade of life. The pathogenesis of the various disease entities is not ...