Journal of Clinical & Medical Case Reports
Case Report
Postoperative Scalp Angiosarcoma was Accompanied by Ipsilateral Cephalic and Facial Herpes Zoster Appearance
Chao Ye1, WeiHong Cao1*, QianWen Zhang2 and YiJian Yu3
1Department of Plastic Surgery, Taizhou Hospital of Zhejiang Province
Affiliated to Wenzhou Medical University, Taizhou, China
2Dermatology Department, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, China
3Department of Pathology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China
2Dermatology Department, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, China
3Department of Pathology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China
Address for Correspondence: WeiHong Cao, Department of Plastic Surgery, Taizhou Hospital
of Zhejiang Province Affiliated to Wenzhou Medical University, No. 150 XiMen Road, Taizhou, Zhejiang 317000, China, E-mail Id: caoweihong@hotmail.com
Submission: 01 November, 2023
Accepted: 05 December, 2023
Published: 08 December, 2023
Copyright: © 2023 Ye C, et al. This is an open-access article
distributed under the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction
in any medium, provided the original work is properly cited.
Keywords: Cutaneous angiosarcoma; Scalp; Herpes zoster Appearance;
Perineural invasion metastasis
Abstract
Background: Cutaneous angiosarcoma is a rare cutaneous
malignancy with poor prognosis. Because of its diverse clinical
manifestations lack of specificity, clinical treatment is difficult.Here we
present a case of postoperative scalp angiosarcoma with ipsilateral
cephalic and facial herpes zoster appearance.
Case Report: An 88-year-old man was diagnosed with scalp angiosarcoma and underwent extensive excision and skin graft. Red induration occurred around the skin graft area of the scalp 1 month after surgery, along with ipilateral head and face blister-like changes and intermittent aggravated neuralgia. Finally, he died 3 months later due to refusal of further treatment. Immunohistochemistry was performed on sarcoma tissue and paracancer tissue obtained by pathological examination. The results indicated that the expression of NGF and TrkA were positive in sarcoma tissue and negative in paracancer tissue.It is speculated that there may be perineural invasion metastasis in angiosarcoma of scalp which is associated with sarcoma progression, increased local recurrence, intense pain, and poor prognosis.
Conclusion: Once cutaneous angiosarcoma patients indicate nerve invasion, immunohistochemical staining of pathological section NGF and TrkA should be performed when necessary to determine whether there is positive expression, so as to determine the possibility of perineural invasion metastasis. When such patients present with vesicular manifestations accompanied by progressive aggravated neuralgia, they should be highly vigilant about the possibility of sarcoma recurrence and perineural invasion metastasis, so as to actively take further treatment measures early to prolong the life of patients as much as possible.
Case Report: An 88-year-old man was diagnosed with scalp angiosarcoma and underwent extensive excision and skin graft. Red induration occurred around the skin graft area of the scalp 1 month after surgery, along with ipilateral head and face blister-like changes and intermittent aggravated neuralgia. Finally, he died 3 months later due to refusal of further treatment. Immunohistochemistry was performed on sarcoma tissue and paracancer tissue obtained by pathological examination. The results indicated that the expression of NGF and TrkA were positive in sarcoma tissue and negative in paracancer tissue.It is speculated that there may be perineural invasion metastasis in angiosarcoma of scalp which is associated with sarcoma progression, increased local recurrence, intense pain, and poor prognosis.
Conclusion: Once cutaneous angiosarcoma patients indicate nerve invasion, immunohistochemical staining of pathological section NGF and TrkA should be performed when necessary to determine whether there is positive expression, so as to determine the possibility of perineural invasion metastasis. When such patients present with vesicular manifestations accompanied by progressive aggravated neuralgia, they should be highly vigilant about the possibility of sarcoma recurrence and perineural invasion metastasis, so as to actively take further treatment measures early to prolong the life of patients as much as possible.