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PD-1, PD-L1, NY-ESO-1, and MAGE-A4 expression in cutaneous angiosarcoma: A case report
Kazuhiko Hashimoto1, Shunji Nishimura, Yu Shinyashiki
1Department of Orthopedic Surgery, Kindai University Hospital, Osaka-Sayama City, Osaka, Japan.
Rationale:
The genomic alteration of cutaneous angiosarcoma (cAS) is complex. Treatment efficacy of immunotherapy for cAS remains controversial and prognosis remains poor. Herein, we report a case of cAS with programmed cell death 1, programmed cell death ligand-1, New York esophageal squamous cell carcinoma-1, and melanoma-associated antigen 4.
Patient Concerns:
A 69-year-old man presented with a chief complaint of left thumb pain, with a soft tissue mass in the palmar side of the thumb. He had no past medical history. Three months prior, the man experienced the pain while scuba diving. He visited a nearby clinic, and magnetic resonance imaging revealed a soft tissue tumor on the palmar side of the thumb. He was referred to our hospital and a marginal excisional biopsy was performed.
Diagnosis:
Pathological findings revealed an angiosarcoma with high-flow serpentine vessels.
Interventions:
An excision was performed from the base of the thumb to achieve a wide margin.
Outcomes:
One year after the treatment, the patient has not experienced recurrence, metastasis, or complications.
Lessons:
Histopathology of the excised specimen was positive for programmed cell death 1, programmed cell death ligand-1, New York esophageal squamous cell carcinoma-1, and melanoma-associated antigen 4; their expression may be a therapeutic target for cAS. Combining immunotherapy with surgical treatment may be effective for cAS.
Insights
This case study highlights a successful treatment for cutaneous angiosarcoma (cAS) using immunotherapy combined with surgery. The patient showed no recurrence after one year, suggesting potential therapeutic targets in specific biomarkers.
Area of Science:
- Oncology
- Immunotherapy
- Surgical Oncology
Background:
- Cutaneous angiosarcoma (cAS) presents complex genomic alterations, with controversial immunotherapy efficacy and poor prognosis.
- This report details a cAS case associated with programmed cell death 1 (PD-1), programmed cell death ligand-1 (PD-L1), New York esophageal squamous cell carcinoma-1 (NY-ESO-1), and melanoma-associated antigen 4 (MAGE-A4).
Observation:
- A 69-year-old male presented with left thumb pain and a soft tissue mass.
- Initial MRI revealed a soft tissue tumor; a marginal excisional biopsy was performed.
- Pathology confirmed angiosarcoma characterized by high-flow serpentine vessels.
Findings:
- Surgical excision with wide margins was performed.
- Histopathology revealed positivity for programmed cell death 1 (PD-1), programmed cell death ligand-1 (PD-L1), New York esophageal squamous cell carcinoma-1 (NY-ESO-1), and melanoma-associated antigen 4 (MAGE-A4).
- One year post-treatment, the patient experienced no recurrence, metastasis, or complications.
Implications:
- The identified biomarkers (PD-1, PD-L1, NY-ESO-1, MAGE-A4) may represent viable therapeutic targets for cAS.
- Combining immunotherapy with surgical intervention could offer an effective treatment strategy for cutaneous angiosarcoma.
- This case suggests a promising approach for managing cAS, potentially improving patient outcomes.
