A case of angiosarcoma successfully treated with chemoradiation therapy

A 62-year-old woman had hit her head on a garage door. Subsequently, a nodule developed 3 months prior to her first visit to our department. On gross examination, there was a tumor presenting as a purplish macule on the parietal region of the head. Histopathological examination of the tumor showed a proliferation of endothelial cells with large nuclei in the dermis, which formed vascular-like structures with distinct lumens. On immunohistochemistry, the tumor cells were positive for CD31, CD34, and D2-40 in the cytoplasm, and ERG in the nucleus, which led us to the diagnosis of angiosarcoma. The tumor was irradiated with an electron ray (70 Gy/35 Fr), followed by chemotherapy using paclitaxel. Due to severe bone marrow suppression, paclitaxel was discontinued after the 3rd course ; subsequently, docetaxel was started and has been continued monthly. At 6 years after the first visit, docetaxel was discontinued because the tumor disappeared clinically ; however, during a suspension of treatment for 10 months, angiosarcoma recurred on the head. The tumor disappeared rapidly after the resumption of docetaxel and the patient has subsequently been treated with docetaxel monthly. The patient is still alive and has experienced no distant metastasis for more than 8years. Angiosarcoma is a high-grade vascular malignant neoplasm. We discuss the usefulness of taxanes for patients with angiosarcoma.