[Diagnosis and treatment of primary mediastinal angiosarcoma]

The results of treatment of 23 patients, suffering primary angiosarcoma (AS), and 7--having mediastinal hemangiopericytoma, were analyzed. Primary mediastinal AS constitutes a quite rare tumor, for its recognition it is necessary to do differential diagnosis from tumors with possible localization in anterior mediastinum. AS differs by more aggressive course and, accordingly, by poorer results of treatment and poorer prognosis as well. Surgical treatment was conducted in 15 patients, including radical operations in 13 (in 7--for AS, in 6--hemangiopericytoma), the combined--in 4. The total survival indices during 3 - 5 yrs after radical operations for AS have had constituted, accordingly, 57.1 and 28.6%, and of recurrence-free survival--42.8 and 28.6%. Chemotherapy as a single method of treatment was conducted in 11 patients, radiation therapy--4. The total survival indices in 3 and 5 yrs follow-up have had constituted 26.6 and 7.1%. Application of taxans in the treatment of AS permits to achieve better results. Radiation therapy is applied in a chemotherapy resistant and recurrent tumors. Surgery constitutes the main method of treatment of mediastinal AS. The standard schemes of chemotherapy are lacking efficacy, the taxans are characterized by higher antitumoral activity.