Angiosarcoma of the chest wall

Our plain-English summary of Angiosarcoma of the chest wall, by T. Suzuki, S. Suzuki, A. Kitami, et al (The Thoracic and Cardiovascular Surgeon, 1996).

The study

• Authors: T. Suzuki, S. Suzuki, A. Kitami, Y. Kamio, G. Hori, T. Mitsuya, H. Ota
• Journal: The Thoracic and Cardiovascular Surgeon
• Published: 1996;44(4):213-5
• Type of article: Case report
• Cited by: 10 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Angiosarcoma is a rare but highly malignant disease. This report presents a 22-year-old male who has survived a primary angiosarcoma arising from the chest wall. The patient had been complaining of anterior chest pain for 3 years. CT and MRI revealed a tumor protruding into the right thoracic cavity from the anterior chest wall but no further findings. First, the tumor was resected using video-assisted thoracoscopy. The pathological diagnosis established from a frozen section was of a benign mesothelioma, but this was changed to angiosarcoma based on findings from a paraffin-embedded specimen. As a consequence, the third rib and intercostal muscles were resected in a second operation. Three years following surgery there was no evidence of tumor recurrence or metastasis. This case supports a suggestion that not all patients with angiosarcomas experience the same level of malignancy.

In plain English

This case report from Japan described a 22-year-old man who had had pain in the right front of his chest for three years. He had no history of radiation treatment or chronic inflammation of the chest. Imaging showed a mass projecting into the chest cavity from the front chest wall. Surgeons removed the tumor, which measured 40 x 30 x 30 mm, with the help of a thoracoscope. A quick frozen-section test during surgery was read as a benign localized mesothelioma. Fuller microscope, immunohistochemical and electron microscope examination changed the diagnosis to angiosarcoma, which the authors described as a rare but highly malignant disease. Sixteen days later, a 9 cm section of the third rib and the nearby intercostal muscles were removed, and 20 milligrams of adriamycin was given into the chest. No remaining tumor was found in that tissue, and there was no recurrence during the three years after surgery. The authors concluded that the case appeared to belong to a small group with a relatively favorable course.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (one patient)
• Who was studied: One 22-year-old man with right anterior chest pain for three years, treated at Showa University Fujigaoka Hospital, Yokohama, Japan
• Exposure: No exposure was studied. The authors report that the patient had no history of irradiation or chronic inflammation of the chest, the factors they say are generally linked to chest wall angiosarcoma. Asbestos is not mentioned.
• Main results:
  • A chest radiograph showed a 30 x 20 mm circular shadow with a sharp margin
  • A frozen section taken during the first (thoracoscopic) operation was diagnosed as a benign localized mesothelioma, so no further resection was done at that time
  • The removed tumor measured 40 x 30 x 30 mm
  • After microscopic, immunohistochemical and electron microscopic findings, the diagnosis was changed from benign mesothelioma to angiosarcoma
  • A second operation was performed 16 days after the first
  • In the second operation the third rib (9 cm in length) and the adjoining intercostal muscles were resected
  • Twenty milligrams of adriamycin was given into the chest
  • No remaining tumor was found in the tissue removed at the second operation
  • There was no tumor recurrence during the three years after surgery
• The authors' conclusion: The authors concluded that this case appears to belong to a small group of chest wall angiosarcomas with a relatively favorable course. They also concluded that certain types of primary chest wall angiosarcoma may not carry so poor a prognosis if they are completely resected.

Topics

Medical terms in this study, explained in our Lexicon: Thoracoscopy, Frozen Section, Mesothelioma, Metastasis.

Related studies

• Chest wall tumour following iodized talc pleurodesis — J.W. Jackson, M.H. Bennett (1973)
• Chest wall resection---alloplastic replacement — L.H. Lampl, H. Loeprecht (1988)
• Chest wall stabilization using plate fixation — J.E. Sherman, A. Salzberg, et al. (1988)
• Malignant mesothelioma presenting as a giant chest, abdominal and pelvic wall mass — Z.H. Shao, X.L. Gao, et al. (2011)
• Tumor extension along chest wall tract after diagnostic intervention in malignant pleural mesothelioma — F. Chen, A. Yoshizawa, et al. (2011)
• Primary pleural epithelioid angiosarcoma. A case report and review of the literature — E. Dainese, B. Pozzi, et al. (2010)

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