Treatment of consistent BRAF/HRAS gene mutation and MYC amplification radiation-induced abdominal wall angiosarcoma with low-dose apatinib: a case report.
机构:[1]Cancer Center, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, 510405 Guangzhou, Guangdong, People’s Republic of China深圳市中医院深圳医学信息中心[2]The First Clinical Medical College, Guangzhou University of Chinese Medicine, 510405 Guangzhou, Guangdong, People’s Republic of China.深圳市中医院深圳医学信息中心
An extremely rare condition, radiation-induced angiosarcoma is characterized by a poor prognosis, high recurrence rate and lack of effective treatment. Herein, we present a case report of a 48-year-old female patient with radiation-induced abdominal wall angiosarcoma who showed a dramatic response to low-dose apatinib.
The patient, who was diagnosed with cervical squamous cell carcinoma 20 years ago, had received radiotherapy and chemotherapy after operation. Angiosarcomas of the abdominal wall appeared 9 years later. After repeated surgical operations and intravenous chemotherapy for the angiosarcomas, the patient developed tumor recurrence and pulmonary metastasis. The abdominal wall tumors showed repeated rupture and bleeding, with poor wound healing. On evaluation, laboratory findings detected the negative serum tumor markers CEA, CA 125, CA 15-3 and CA 19-9. Imaging showed multiple subcutaneous nodules and masses in the abdominal wall, accompanied by suspected small subpleural nodule at the lower lobe of the right lung. Immunohistochemistry of previous surgical pathology indicated that CD31, ERG and Vim were positive. The result of whole exome sequencing suggested the mutations of BRAF and HRAS, and the amplification of MYC. Based on the above results, the patient was clinically diagnosed with radiation-induced angiosarcoma of the abdominal wall with pulmonary metastasis. The patient was treated with low-dose apatinib and rejected reoperation or chemotherapy.
At the 6-month follow-up visit, the abdominal wall lesions that had previously ruptured stopped bleeding and showed significant shrinkage. Imaging showed that most of the abdominal wall lesions had partially regressed, and some of the lesions on the abdominal wall and the suspected lesion of subpleural nodule at the lower lobe of the right lung had disappeared.
We described this case and reviewed the literature on radiation-related angiosarcoma. Importantly, this case suggests that apatinib may be an effective and sensitive treatment for radiation-induced angiosarcoma even at the lowest dosage, without aggravating the bleeding of lesions.
基金:
the Science and Technology Project of
Guangzhou (Grant No. 201707010299), Science and Technology Project of
Guangdong Province (Grant No. 2016B090918059) and Medical Scientific
Research Foundation of Guangdong Province (Grant No. B2019148).
语种:
外文
PubmedID:
中科院(CAS)分区:
出版当年[2018]版:
大类|3 区医学
小类|3 区肿瘤学
最新[2025]版:
大类|3 区医学
小类|3 区肿瘤学
第一作者:
第一作者机构:[1]Cancer Center, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, 510405 Guangzhou, Guangdong, People’s Republic of China
通讯作者:
推荐引用方式(GB/T 7714):
Guan Jieshan,Luo Zhijie,Xiao Zhiwei,et al.Treatment of consistent BRAF/HRAS gene mutation and MYC amplification radiation-induced abdominal wall angiosarcoma with low-dose apatinib: a case report.[J].BMC cancer.2019,19(1):1188.doi:10.1186/s12885-019-6351-4.
APA:
Guan Jieshan,Luo Zhijie,Xiao Zhiwei,Xie Yubin&Lin Lizhu.(2019).Treatment of consistent BRAF/HRAS gene mutation and MYC amplification radiation-induced abdominal wall angiosarcoma with low-dose apatinib: a case report..BMC cancer,19,(1)
MLA:
Guan Jieshan,et al."Treatment of consistent BRAF/HRAS gene mutation and MYC amplification radiation-induced abdominal wall angiosarcoma with low-dose apatinib: a case report.".BMC cancer 19..1(2019):1188