Delayed diagnosis of radiation - associated cutaneous angiosarcoma

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Résumé

Angiosarcoma is most frequently occurring in patients treated for a previous cancer with radiation therapy. Our aim
was to measure the time between the first signs found by the patient and the first biopsy, and the time before the final
diagnosis of radiation-associated angiosarcoma (RAAS) and to analyse the reasons for delayed diagnosis. Four patients
met the inclusion criteria. Three had cutaneous RAAS and one had suprapubic cutaneous RAAS after treatment for
cancer. The intervals between the first cutaneous sign recorded by the patient and the diagnosis of RAAS were 9 to
37 months. The initial diagnosis by the non-specialist pathologist was a benign vascular lesion. Review of the initial
biopsy was consistent with RAAS in 3 cases and with AVL in 1 case. Clinicians should alert pathogists when a vascular
lesion is larger than 5 mm in the context of irradiated skin. Histology review by an expert should be recommended.

Mots-clés

Angiosarcoma; Radiation; Pathology; Diagnosis; Atypical vascular lesion; Chemotherapy