Abstract
Background/Aim: Angiosarcoma of primary gynecologic origin is an extremely rare and highly malignant tumor of endothelial origin with a 5-year survival rate of less than 35%. To date, only 61 cases have been described in the literature. The aim of this study was to present more cases and discuss potential therapy options. Case Report: The following case series presents three cases of gynecologic angiosarcomas that were under therapy at the Charité – University medicine of Berlin from June 2014 to February 2018. Results: Two of the cases deal with primary angiosarcomas of the uterus whereas the third case was diagnosed after the suspicion of a recurrence of a poorly differentiated squamous cell carcinoma of the cervix uteri. In case one a 75-year old patient with initial postmenopausal bleeding and a tumor mass of the uterus is described. After surgery a hemangiosarcoma of the uterus was confirmed. After two months the patient presented with a presacral peritoneal sarcomatosis. Chemotherapy of weekly paclitaxel was administered. Case two deals with a patient presenting with abdominal pain. A uterine sarcoma with infiltration of the parametry and angiosarcomatosis peritonei was diagnosed during an emergency laparotomy because of spontaneous peritoneal bleeding. Moreover, osseous metastasis was found. The patient underwent weekly paclitaxel. Due to tumor progression, chemotherapy was changed to doxorubicin and olaratumab and radiotherapy was induced. The patient died 33 months after initial diagnosis. Case three describes a 34-year old patient with suspected local recurrence of cervical cancer with infiltration of the bladder. During TURB an angiosarcoma was found. Following laparoscopy revealed peritoneal metastasis. The patient underwent weekly paclitaxel followed by a paclitaxel and pazopanib maintainance therapy which showed a regression. Due to progression afterwards, chemotherapy was changed to gemcitabine and docetaxel and gemcitabine monotherapy. The patient died 33 months after initial diagnosis. Conclusion: Even though there is no evidence on standard treatment of this extremely rare and aggressive tumor entity of the female genital tract the patients showed the longest stability of disease during chemotherapy with weekly paclitaxel.
- Angiosarcoma
- hemangiosarcoma
- gynaecology
- cancer
- uterine sarcoma
- ovarian sarcoma
- chemotherapy
- paclitaxel
- laparotomy
- osseous metastasis
Footnotes
Authors' Contributions
Lukas Chinczewski and Sara Alavi were responsible for the study coordination, analysis and interpretation of data and drafting of the manuscript. Lisa Dröge, Klaus Pietzner, Radoslav Chekerov and Jalid Sehouli were involved in the acquisition of data as well as the analysis and interpretation of data and critical revision. Eliane Taube was responsible for the pathological findings and Felix Feldhaus for the radiological findings. All Authors discussed the results and contributed to the final manuscript.
Conflicts of Interest
Dr. Sehouli reports research funding and adboard from Bayer, Lilly and PhamaMar, outside the submitted work; Dr. Pietzner reports personal fees from AstraZeneca, personal fees and travel support from Roche, personal fees from MSD, personal fees from PharmaMar, personal fees and travel support from Tesaro/GSK, outside the submitted work; Mr. Chinczewski, Dr. Taube, Dr. Feldhaus, Dr. Chekerov, Dr. Dröge, Dr. Muallem and Dr. Alavi have nothing to disclose.
- Received June 29, 2020.
- Revision received July 17, 2020.
- Accepted July 20, 2020.
- Copyright© 2020, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved
This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.