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Therapeutic options for primary meningeal angiosarcoma: A case report
Isaac Melguizo-Gavilanes1, George Snipes2, Iader Rodríguez-Márquez3
1Department of Neuro-Oncology, Aurora Cancer Care, Milwaukee, Wisconsin, United States.
Surgical Neurology International
|September 3, 2020
Summary
Primary angiosarcoma of the central nervous system (PACNS) is rare. This case shows paclitaxel offered a modest response in meningeal PACNS, suggesting surgery and radiotherapy are key, with radiosurgery as a promising option.
Area of Science:
- Neuro-oncology
- Vascular Neoplasms
Background:
- Primary angiosarcoma of the central nervous system (PACNS) is an extremely rare malignancy.
- Meninges are an uncommon origin site for PACNS.
- This report details a recurrent meningeal PACNS case.
Observation:
- A 36-year-old male presented with headaches and visual field deficits.
- Neuroimaging revealed a tentorial tumor with an occipital lobe hematoma.
- Pathology confirmed malignant endothelial cell angiosarcoma.
Findings:
- The patient received surgery, radiotherapy, and stereotactic radiosurgery.
- Adjuvant radiation therapy was followed by disease progression.
- Weekly paclitaxel treatment resulted in stable disease initially.
- Tumor progression led to the patient's death.
Implications:
- Meningeal PACNS should be considered in malignant lesions with intracranial hemorrhage.
- Paclitaxel may offer a modest clinical response in PACNS.
- Combined treatment of surgery and radiotherapy is crucial.
- Stereotactic radiosurgery shows promise as a treatment modality.
