Case ReportPulmonary metastatic angiosarcoma from scalp with fatal complication: A case report

- AS of the scalp is rapidly progressive, the potential of metastatic lesions should be considered, and a preoperative chest CT may be recommended.
- AS with Pulmonary metastasis had repeated hemoptysis pneumothorax.
- Tissue confirmation following management of complications and chemotherapy with paclitaxel resulted in good prognosis
- Cytology of pleural effusion maybe first considered for differential diagnosis due to lesser invasive procedure.

IntroductionAngiosarcoma is a rare malignant neoplasm with poor prognosis. Angiosarcoma of the scalp is frequently recurs locally, and metastasizes early despite various treatments. The common sites of metastatic are lung, liver, and lymph nodes. Pulmonary metastasis with hemoptysis and pneumothorax is rare but threatening.Presentation of caseA 77-year-old male had recurrent angiosarcoma of the scalp even with post operation radiotherapy. At the same time, recurrent pneumothorax was noted, thus he underwent wedge resection of the right upper lobe of the lung plus pleural biopsy. The final pathologic report of cystic lesions showed metastatic Angiosarcoma. He received intravenous paclitaxel and the lung lesions dramatically diminished subsequently.DiscussionPulmonary metastasis from soft tissue sarcoma had fatal complications and poor prognosis. Metastases of AS to the lung have a well-described morphology on CT scan, but appear to be hypometabolic on PET scan and are easily misinterpreted as benign cysts.ConclusionAngiosarcoma is a rare but highly vascular invasive endothelial tumor that generally metastasizes to the lung. It could cause repeated hemoptysis pneumothorax and pleural effusion. Preoperative chest CT may be recommended routinely. Aggressive treatment resulted in not only symptoms control but also good prognosis.