Ufuk YETKİN, Uysal YAPUCU, Figen TÜRK, Demet ETİT, Ali GÜRBÜZ

Radyoterapi sonrası geç dönem oluşumlu bir dev angiosarkoma: Olgu sunumu

Anjiosarkomlar, damar endotelinden çıkan ve damar yapısını taklit eden, nadir rastlanan malign tümörlerdendir. Radyoterapi sonrası sarkomlar sık görülmemesine rağmen, değişik tipte malign tümörler için uygulanan radyoterapiyi takiben gelişen angiosarkomlar bildirilmiştir. Radyoterapi He sarkomun oluşması arasındaki süre oldukça değişkendir ve genellikle bu süre 10 yılı aşar. Bu çalışmada cerrahi olarak total ekstirpasyonunu gerçekleştirdiğimiz ve Biyolojisinde 13 yıl önce Hodgkin hastalığı nedeniyle gördüğü radyoterapi sonrası geç dönemde geliştiğine inandığımız 30 yaşındaki bir hastada saptanmış sağ ön hemitoraks üst kadranındaki dev anjiosarkom olgusunu sunmayı amaçladık. Hastanın tanısına ve cerrahi tedavisinin planlanmasına yönelik gerçekleştirdiğimiz yöntemleri literatür ışığı altında irdeledik.

Anahtar Kelimeler:

Radyasyon etkileri, Biyopsi, ince-iğne, Tanı teknik ve işlemleri, Cerrahi işlemler, operatif, Radyoterapi, Radyasyon hasarı, Neoplazmlar, damar dokusu, Erkek, Hodgkin hastalığı, Hemanjiyosarkom, Erişkin

A case with giant angiosarcoma developed in the late period after irradiation: A case report

Angiosarcomas are malignant tumors originating from vascular endothelium and imitating the vascular structure. Postirridation sarcomas are not frequent but angiosarcomas were reported after radiothreapy for different malignant tumor types. The period between radiotherapy and sarcoma development is variable and generally over 10 years. In this study we aimed to present a 30 years old patient with a giant angiosarcoma at right anterior hemithorax in upper quadrant which we extirpated totally. We believed that it developed 13 years after the radiotherapy for Hodgkin disease. Our methods for diagnose and surgical therapy planning were evaluated under the light of literature.

Keywords:

Radiation Effects, Biopsy, Fine-Needle, Diagnostic Techniques and Procedures, Surgical Procedures, Operative, Radiotherapy, Radiation Injuries, Neoplasms, Vascular Tissue, Male, Hodgkin Disease, Hemangiosarcoma, Adult,

PDF

___

1. Khalifa MA. Solitary fibrous tumors: a series of lesions, some in unusual sites. South Med J 1997;90:793-797.
2. Requena L, Kutzner H, Mentzel T, Duran R, Rodriguez -Peralto JL. Benign vascular proliferations in irradiated skin. Am J Surg Pathol 2002;26(3):328-337.
3. Killion MJ, Brodovsky HS, Schwarting R. Pericardial angiosarcoma after mediastinal irradiation for seminoma: a case report and review of the literature. Cancer 1996;78:912-917.
4. Meis-Kindblom JM, Kindblom LG. Angiosarcoma of soft tissue: a study of 80 cases. Am J Surg Pathol 1998;22:683-689.
5. Fletcher CDM, Beham A, Bekir S, et al. Epithelioid angiosarcoma of deep soft tissue:a distinctive tumor readily mistaken for an epithelial neoplasm. Am J Surg Pathol 1991;15:915-921.
6. Schmitz-Rixen, Horsch S, Arnold G, Peters PE. Angiosarcoma in primary lymphedema of the lower extremity-Stewart Treves syndrome. Lymphology 1984;17:50-54.
7. Kuten A, Sapir D, Cohen Y, Haim N, Robinson E. Postirradiation soft tissue sarcoma occuring in breast cancer patients: report of seven cases and results of combination chemotherapy. J Surg Oncol 1985;28:168-171.
8. Badwe RA, Hanby AM, Fentiman IS, Chaudary MA. Angiosarcoma of the skin overlying an irradiated breast. Breast Cancer Res Treat 1991;19:69-72.
9. Fineberg S, Rosen PP. Cutaneous angiosarcoma and atypical vascular lesions of the skin and breast after radiation therapy for breast carcinoma Am J Clin Pathol 1994;102:757-763.
10. Weiss WS, Goldblum RJ. Malignant Vascular Tumors. In: Weiss WS, Goldblum RJ. Soft Tissue Tumors. St.Louis: Mosby Inc. 2001; p.917-952.
11. Marchal C, Weber B, de Lafontan B. Nine breast angiosarcomas after conservative treatment for breast carsinoma: a survey from French comprehensive cancer centers. İin J Radiat Oncol Biol Phys 1999;44:113-119.
12. Moskaluk CA, Merino MJ, Danforth DN, et al. Low grade angiosarcoma of the skin of the breast:a complication of lumpectomy and radiation therapy for breast carcinoma. Hum Pathol 1992;23:710-714.
13. Kardamakis D. Case reports: primary hemangiosarcoma of the mediastinum. Lung Cancer 1996;16:81-85.
14. Lee KC. Angiosarcoma following treatment of testicular seminoma:case report and literature review. J Urol 1995;153:1005-1058.
15. Abratt PP. Angiosarcoma of the superior vena cava. Cancer 1983;52:740-743.
16. Miller MM. Primary angiosarcoma of the innominate vein: a case report with resection and long-term survival. J Thorac Cardiovasc Surg 1985;90:148-151.
17. Alifano M, Porrello C, Forti Parri SN, Casablanca G, Boaron M. Primary angiosarcoma of the chest wall. J Cardiovasc Surg (Torino) 2002;43(1):127-128.
18. Feigenberg SJ, Price Mendenhall N, Reith JD, Ward JR, Copeland EM. Angiosarcoma after breast-conserving theraphy:experience with hyperfractionated radiotherapy. Int J Radiat Oncol Biol Phys 2002;52(3):620-626.
19. Fujimoto M, Kiyosawa T, Murata S, et al. Vascular endothelial growth factor in angiosarcoma. Anticancer Res 1998;18:25-28.