Angiosarcoma developing after curative induction chemotherapy and radiotherapy for locally advanced squamous cell carcinoma of the larynx.

Abstract

Angiosarcoma arising after radiation is described in breast cancer but occurs elsewhere. Here, we present an angiosarcoma of the neck occurring after curative chemoradiation. This is a case of angiosarcoma developing 5 years after curative therapy for T3N0 squamous cell carcinoma of the supraglottic larynx. Therapy consisted of 3 cycles of induction cisplatin/5-fluorouracil chemotherapy followed by radiotherapy. The patient did well until developing a rapidly progressive lesion of the left neck. Examination showed a 7-cm mass and biopsy revealed angiosarcoma. CT scans assessed the local extent of the tumor and ruled out metastatic disease prior to initiating therapy. Therapy consisted of 4 cycles of paclitaxel chemotherapy. At completion, examination revealed mild induration of the neck with near-complete resolution of the mass. Imaging confirmed this excellent response. This rare therapy-related second malignancy developed after curative larynx-preserving treatment. Paclitaxel was an effective therapy in this setting.