Recurrent angiosarcoma of scalp with opsoclonus myoclonus syndrome: role of salvage treatment.
Kannan PeriasamyNamrata DasDivya KhoslaRakesh KapoorPublished in: BMJ case reports (2021)
Cutaneous angiosarcoma is a type of rare and locally aggressive malignancy requiring individualised treatment owing to paucity of randomised trials. We present the case of a middle-aged cancer survivor with locally advanced angiosarcoma of scalp managed with surgery, radiotherapy, chemotherapy and targeted therapy over a course of 6 years for two recurrences. The first recurrence was preceded by opsoclonus myoclonus syndrome, a type of paraneoplastic neurological syndrome (PNS), rarely reported in sarcomas. The second recurrence had a rapid clinical course, which led to a therapeutic dilemma of best supportive care versus active management. A trial of weekly paclitaxel was started that was continued for a total of 12 cycles with good objective clinical response. Presently, he is tolerating maintenance pazopanib well and is symptom free for 6 months. In cutaneous angiosarcoma patients, PNS may be a harbinger of recurrence and aggressive, multimodality treatment helps prolong survival.
Keyphrases
- locally advanced
- clinical trial
- middle aged
- squamous cell carcinoma
- healthcare
- radiation therapy
- rectal cancer
- minimally invasive
- randomized controlled trial
- lymph node
- early stage
- newly diagnosed
- open label
- study protocol
- acute coronary syndrome
- palliative care
- quality improvement
- combination therapy
- coronary artery disease
- blood brain barrier
- health insurance
- squamous cell
- childhood cancer