Intra-Axial Metastatic Angiosarcoma of the Central Nervous System Associated with Anemia, Pulmonary Tuberculosis and Short Survival

Introduction Angiosarcoma (AG) is a malignant mesenchymal neoplasm that predominantly affects the soft tissues and, to variable degrees, expresses themorphological and functional characteristics of the endothelium. The incidence of sarcomas of the central nervous system(CNS) is low (0.5% to 2.7%), and AGs involving the brain are even rarer. Case Description A 45-year-old male patient presented with complaints of headache, nausea, and vomiting. An examination showed bilateral papilledema and a right lung pleurotomy. The patient's previous history included drug addiction, pulmonary tuberculosis, lung abscess, pleural empyema, and pulmonary artery embolization for severe hemoptysis. Computed tomography/magnetic resonance imaging scans revealed a large intra-axial lesion extending into the right parietal and temporal lobes, with hemorrhagic zones. The patient underwent surgical resection of the lesion. Microscopy showed a poorly-differentiated, high-grade malignant tumor composed of plump/epithelioid cells forming small vascular spaces and solid nests, compatible with AG.In the postoperative period, the patient developed recurrent hemoptysis. A biopsy of the tissues adjacent to the pleurotomy determined the diagnosis of pulmonary AG. At 30 days after the resection, the patient died from hemoptysis, hemothorax, lung atelectasis, and intracranial hypertension related to the recurrence of the brain tumor. Conclusion Angiosarcoma is a rare neoplasia related to short survival due to the high proliferative index, which must be considered in patients presenting hemorrhagic tumors. No specific genetic abnormalities have been described for this neoplasia.

Angiosarcoma of the head and neck

Introduction Angiosarcoma of the head and neck is a rare vascular sarcoma associated with high rates of local recurrence and distant metastasis and a poor prognosis. Objective We describe our experience treating patients with angiosarcoma of the head and neck to evaluate the outcomes, patterns of failure, and current treatments. Methods We identified six patients with angiosarcoma of the head and neck and treated at our institution between 2000 and 2013. We compared our results to the literature from 1979 to 2013. Results Mean follow-up was 42 months. Local recurrence rate was 50% with diseasespecific survival and 2-year disease-free survival rates of 33.3 and 20%, respectively. Prognostic factors included tumor size > 5 cm and surgical margin status, with no correlation between histologic grade and survival. Combined-modality therapy was only used for aggressive tumors with positive surgical margins but is suggested to improve local control and overall survival. Conclusions Our data series supports that angiosarcoma of the head and neck has a high rate of recurrence and is associated with a poor prognosis, despite current combined-modality therapy. The study highlights the importance of attaining negative margins during surgical resection, the utility of adjuvant therapies, as well as the need for continued research in developing new management strategies.

Angiosarcoma primario de mama

Primary angiosarcoma of the breast represent 0.04 per cent of the malignant neoplasm of the gland and is considered the more aggressive and lethal. Its biological behavior is related to sixe and histologic grade. There are no prospective studies that allow conclusions about the utility of chemo-radiotherapy adjuvant treatment; mastectomy is the best therapy

Cardiopatia neoplásica / Neoplasic cardiopathy

Mesmo diante do avanço propedêutico observado na Cardiologia moderna, devido à sua freqüência clínica realmente incomum, a chamada Cardiopatia Neoplásica exibe reduzido reconhecimento diagnóstico na prática médica. Os tumores cardíacos primários benignos sao menos raros do que os malignos, com predominância, neste aspecto, dos mixomas, ao passo que, em termos de câncer metastático, as neoplasias broncogênicas e de mama sao as que mais envolvem o coraçao durante seu curso evolutivo.

Angiosarcoma de mama: reporte de un caso y revisión de la literatura / Angiosarcoma of the breast: a case report and review of the literature

Se presenta un caso de una paciente de 22 años de edad, con tres meses de evolución, con una mancha roja en casi la totalidad de la mama derecha, sin una masa bien definida. La mama izquierda y zonas linfoportadoras locorregionales fueron normales. Una xeromastografía demostró aumento en la densidad de la mama derecha y discreto adelgazamiento de la piel. el diagnóstico clínico fue angiosarcoma vs. hemangioma de mama. El estudio histológico de una biopsia incisional demostró nagiosarcoma bien diferenciado. Se realizó una incisión local amplia, dando margen para lograr bordes quirúrgicos libres de tumor; se incluyó la glándula derecha, parte del pectoral mayor, el pectoral menor y disección de ganglios linfáticos axilares bajos. El reporte del estudio histopatológico definitivo fue de angiosarcoma bien diferenciado de mama. La evolución postoperatoria fue satisfactoria. Actualmente, a tres años de la cirugía, se encuentra viva y libre de enfermedad. Se realiza una revisión de la literatura médica