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Primary central nervous system angiosarcoma with recurrent acute subdural hematoma.
Marc Valera-Melé1, Juan Vicente Darriba Allés1, Fernando Ruiz Juretschke1
1Department of Neurosurgery, Hospital General Universitario Gregorio Marañón, Calle Doctor Esquerdo 46, 28007 Madrid, Spain.
Neurocirugia (English Edition)
|June 20, 2022
Summary
Primary central nervous system angiosarcoma is a rare, aggressive tumor. This case highlights a lethal complication and emphasizes gross-total resection with adjuvant therapy for this unusual brain cancer.
Area of Science:
- Neuro-oncology
- Surgical Pathology
Background:
- Angiosarcoma is a rare sarcoma, infrequently presenting as a primary tumor within the central nervous system (CNS).
- CNS angiosarcomas can cause rapid neurological decline and are associated with a poor prognosis.
Observation:
- A 41-year-old male presented with a right frontal hemorrhagic lesion.
- Initial surgery and histopathology confirmed primary CNS angiosarcoma.
- Adjuvant chemotherapy and radiotherapy were administered post-operatively.
Findings:
- A 5-month follow-up MRI revealed two new lesions and an acute subdural hematoma, indicating tumor recurrence.
- Second surgery identified tumoral membranes on the dura mater.
- The patient succumbed to recurrent subdural hematoma.
Implications:
- This case underscores the aggressive nature and potential for lethal complications of primary CNS angiosarcoma.
- Gross-total resection combined with adjuvant radiotherapy appears to be the optimal treatment strategy based on literature review.
- Further research into effective therapeutic modalities for CNS angiosarcoma is warranted.
