伴全身多处转移的头部血管肉瘤1例

患者男,53岁。头部丘疹1年,肿块5个月。组织病理:真皮内可见内含红细胞的不规则管腔相互融合,浸润生长,管腔衬附细胞大小不一,核大深染,胞浆丰富,核分裂易见,异型性明显。免疫组化:CD31,CD34阳性;S-100,SMA,Des阴性。诊断:血管肉瘤。经重组人血管内皮抑制素注射液及紫杉醇方案化疗10周期后皮损缩小,因无手术切除指征,遂予局部放疗。4个月前患者右小腿出现一包块,术后病理证实为血管肉瘤。1个月前PET/CT示右小腿肌组织、左侧腮腺、盆腔、右侧腹股沟至腘窝淋巴结、右侧肱骨头均考虑恶性病变。行长春瑞滨、顺铂及重组人血管内皮抑制素注射液化疗。

A Case of Angiosarcoma of the Scalp complicated with multiple metastasis

A 53-year-old male have presented with papules on head for one year,mass for five months.Pathological examnation showed luminal lining attached cells were of different sizes,with abundant cytoplasm,prominent nuclei with mitosis and significant atypia.Immunohistochemical staining showed that the tumor cells expressed CD31 and CD34,did not express S-100,SMA and Des.The diagnosis was angiosarcoma.After 10 cycles of recombinant human endostatin and paclitaxel chemotherapy,skin lesions of patients were partially remitted.There was no surgical resection indicated,so the patient was given local radiotherapy.Four months ago,the skin lesions relapsed with a mass on the right leg,which was confirmed as angiosarcoma by pathological examination.One month ago,PET/CT scanning showed multiple metastasis of the right calf muscle,the left parotid gland,the pelvic,the right groin to the popliteal lymph nodes and the right humeral head.Subsequently,the patient was treated with vinorelbine,cisplatin and recombinant haman endostatin for chemotherapy.