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Recurrent angiosarcoma of scalp with opsoclonus myoclonus syndrome: role of salvage treatment
  1. Kannan Periasamy1,
  2. Namrata Das1,
  3. Divya Khosla1 and
  4. Rakesh Kapoor1,2
  1. 1Department of Radiotherapy and Oncology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
  2. 2Director, Homi Bhabha Cancer Hospital, Sangrur, India
  1. Correspondence to Dr Namrata Das; namrata747{at}gmail.com

Abstract

Cutaneous angiosarcoma is a type of rare and locally aggressive malignancy requiring individualised treatment owing to paucity of randomised trials. We present the case of a middle-aged cancer survivor with locally advanced angiosarcoma of scalp managed with surgery, radiotherapy, chemotherapy and targeted therapy over a course of 6 years for two recurrences. The first recurrence was preceded by opsoclonus myoclonus syndrome, a type of paraneoplastic neurological syndrome (PNS), rarely reported in sarcomas. The second recurrence had a rapid clinical course, which led to a therapeutic dilemma of best supportive care versus active management. A trial of weekly paclitaxel was started that was continued for a total of 12 cycles with good objective clinical response. Presently, he is tolerating maintenance pazopanib well and is symptom free for 6 months. In cutaneous angiosarcoma patients, PNS may be a harbinger of recurrence and aggressive, multimodality treatment helps prolong survival.

  • oncology
  • chemotherapy
  • radiotherapy
  • dermatology
  • neurology

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Footnotes

  • Twitter @namratadas

  • Contributors KP and ND: Conception, design of work and drafting of manuscript. DK and RK: Revision and final approval of manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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