Metastatic Primary Pulmonary Angiosarcoma

Brendan F. Judy, Jarrod D. Predina, Jay Mittal, Charuhas Deshpande, Sunil Singhal
DOI: 10.4236/ss.2011.23026                

Abstract

Angiosarcoma is an extremely aggressive tumor with a high rate of mortality. It can arise in any tissue of the body and is most commonly found in the skin and soft tissue[1]. Pulmonary angiosarcoma is usually secondary to a primary location of the body and presents as both solitary and multiple nodules. Primary pulmonary angiosarcoma is a rare disease with less than 20 cases reported in the English literature. In our report we present a case of metastatic primary pulmonary angiosarcoma involving the most ( > 100) pulmonary nodules known to date. Novel treatment strategy using an anti-angiogenic inhibitor was used to treat this disease for the first time to our knowledge; however, it was unsuccessful in controlling disease progression. This report reviews the literature of this rare and devastating disease.

Keywords

Angiosarcoma; Pulmonary; Tumor; Surgery

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Y. B. Chen, L. C. Guo, L. Yang, et al., “Angiosarcoma of the Lung: 2 Cases Report and Literature Reviewed,” Lung Cancer, Vol. 70, No. 3, 2010, pp. 352-356. doi:10.1016/j.lungcan.2010.09.002
[2]	A. M. Patel and J. H. Ryu, “Angiosarcoma in the Lung,” Chest, Vol. 103, No. 5, 1993, pp. 1531-1535. doi:10.1378/chest.103.5.1531
[3]	R. Wilson, S. Glaros, R. K. Brown, et al., “Complete Radiographic Response of Primary Pulmonary Angiosa- Rcomas Following Gemcitabine and Taxotere,” Lung Cancer, Vol. 61, No. 1, 2008, pp. 131-136. doi:10.1016/j.lungcan.2007.12.006
[4]	K. Kojima, I. Okamoto, S. Ushijima, et al., “Successful Treatment of Primary Pulmonary Angiosarcoma,” Chest, Vol. 124, No. 6, 2003, pp. 2397-2400. doi:10.1378/chest.124.6.2397
[5]	P. Saint-Blancard, K. Hardy, A. Bonnichon, et al., “Three-Year Survival after Treatment of a Primary Pulmonary Angiosarcoma,” Revue de Pneumologie Clinique, Vol. 63, No. 1, 2007, pp. 55-58.
[6]	A. P. Stout, “A Method of Teaching Postgraduate Patho- Logy and the Importance of Correlating Research Knowledge,” Perspectives in Biology and Medicine, Vol. 9, No. 3, 1966, pp. 433-435.
[7]	S. A. Pandit, P. N. Fiedler and J. L. Westcott, “Primary Angiosarcoma of the Lung,” Annals of Diagnostic Pathology, Vol. 9, No. 5, 2005, pp. 302-304. doi:10.1016/j.anndiagpath.2005.04.001
[8]	S. L. Primack, T. E. Hartman, K. S. Lee and N. L. Muller, “Pulmonary Nodules and the CT Halo Sign,” Radiology, Vol. 190, No. 2, 1994, pp. 513-515.
[9]	R. G. Spragg, P. L. Wolf, P. Haghighi, et al., “Angiosarcoma of the Lung with Fatal Pulmonary Hemorrhage,” American Journal of Medicine, Vol. 74, No. 6, 1983, pp. 1072-1076. doi:10.1016/0002-9343(83)90821-5
[10]	C. Adem, M. C. Aubry, H. D. Tazelaar and J. L. Myers, “Metastatic Angiosarcoma Masquerading as Diffuse Pulmonary Hemorrhage: Clinicopathologic Analysis of 7 New Patients,” Archives of Pathology & Laboratory Medicine, Vol. 125, No. 12, 2001, pp. 1562-1565.
[11]	E. A. Bacha, C. D. Wright, H. C. Grillo, et al., “Surgical Treatment of Primary Pulmonary Sarcomas,” European Journal of Cardio-Thoracic Surgery, Vol. 15, No. 4, 1999, pp. 456-460. doi:10.1016/S1010-7940(99)00045-7
[12]	G. A. Carillo, M. A. Carretero, J. E. Vazquez, et al., “Epithelioid Angiosarcoma of the Lung with Pleural Metastases: A Rare Cause of Haemoptysis Clinicopathological Conference,” Heart Lung Circ, Vol. 19, No. 10, pp. 624-628.
[13]	S. L. Segal, G. S. Lenchner, A. V. Cichelli, et al., “Angiosarcoma Presenting as Diffuse Alveolar Hemorrhage,” Chest, Vol. 94, No. 1, 1988, pp. 214-216. doi:10.1378/chest.94.1.214
[14]	S. A. Yousem, “Angiosarcoma Presenting in the Lung,” Archives of Pathology & Laboratory Medicine, Vol. 110, No. 2, 1986, pp. 112-115.
[15]	C. A. Holden, M. F. Spittle and E. W. Jones, “Angiosarcoma of the Face and Scalp, Prognosis and Treatment,” Cancer, Vol. 59, No. 5, 1987, pp. 1046-1057. doi:10.1002/1097-0142(19870301)59:5<1046::AID-CNCR2820590533>3.0.CO;2-6
[16]	R. Sasaki, T. Soejima, K. Kishi, et al., “Angiosarcoma Treated with Radiotherapy: Impact of Tumor Type and Size on Outcome,” International Journal of Radiation Oncology Biology Physics, Vol. 52, No. 4, 2002, pp. 1032-1040. doi:10.1016/S0360-3016(01)02753-5
[17]	M. Masuzawa, N. Mochida, T. Amano, et al., “Evaluation of Recombinant Interleukin-2 Immunotherapy for Human Hemangiosarcoma in a SCID Mice Model (WB-SCID),” Journal of Dermatological Science, Vol. 27, No. 2, 2001, pp. 88-94. doi:10.1016/S0923-1811(01)00103-7
[18]	H. Ihda, Y. Tokura, M. Fushimi, et al., “Malignant Hemangioendothelioma,” International Journal of Dermatology, Vol. 34, No. 11, 1995, pp. 811-816. doi:10.1111/j.1365-4362.1995.tb04406.x
[19]	C. Atasoy, S. Fitoz, H. Yigit, et al., “Radiographic, CT, and MRI Findings in Primary Pulmonary Angiosarcoma,” Clinical Imaging, Vol. 25, No. 5, 2001, pp. 337-340. doi:10.1016/S0899-7071(01)00302-3
[20]	K. M. Leu, L. J. Ostruszka, D. Shewach, et al., “Laboratory and Clinical Evidence of Synergistic Cytotoxicity of Sequential Treatment with Gemcitabine Followed by Docetaxel in the Treatment of Sarcoma,” Journal of Clinical Oncology, Vol. 22, No. 9, 2004, pp. 1706-1712. doi:10.1200/JCO.2004.08.043
[21]	K. Okamoto, M. Ocker, D. Neureiter, et al., “Bcl-2-Specific Sirnas Restore Gemcitabine Sensitivity in Human Pancreatic Cancer Cells,” Journal of Cellular and Molecular Medicine, Vol. 11, No. 2, 2007, pp. 349-361. doi:10.1111/j.1582-4934.2007.00013.x
[22]	L. Ricotti, A. Tesei, F. De Paola, et al., “In Vitro Schedule -Dependent Interaction between Docetaxel and Gemcitabine in Human Gastric Cancer Cell Lines,” Clinical Cancer Research, Vol. 9, No. 2, 2003, pp. 900-905.