老年人头面部血管肉瘤七例分析

【摘要】 目的 探讨血管肉瘤的临床特点及疗效。 方法 回顾性分析2004年1月至2012年3月收治的血管肉瘤患者的临床资料，对肿瘤的临床表现、治疗方法和结果进行观察。结果 7例患者，男4例，女3例，中位年龄67岁（37 ~ 77岁）。7例患者中，不规则结节样肿块伴破溃4例，局部溃疡1例，红色不规则结节2例。入院后均予手术治疗，部分患者予术后辅助治疗。术后组织病理见肿瘤细胞分化程度不同，有异形，内皮细胞明显增生，均诊断为头皮原发的血管肉瘤。免疫组化：CD31、CD34均阳性。术后4例复发，首次复发中位时间为3.5个月（1 ~ 6个月），1例5个月后发现脑组织转移，2例死亡。结论 血管肉瘤是少见的恶性肿瘤，临床表现多变，局部广泛切除为治疗的基础，辅助治疗对改善其预后起到积极的作用。

Angiosarcoma of the face and scalp in the elderly: an analysis of seven cases

FENG Zi-hao, LIU Jia-qi, LU Nan-hang, ZHANG Yong, LIU Ning-hua, QI Fa-zhi. Department of Plastic Surgery, Zhongshan Hospital of Fudan University, Shanghai 200032, China Corresponding author: QI Fa-zhi, Email: qi.fazhi@zs-hospital.sh.cn 【Abstract】 Objective To assess clinical features and treatment of angiosarcoma. Methods A retrospective study was carried out among seven patients hospitalized for angiosarcoma in the Department of Plastic Surgery, Zhongshan Hospital of Fudan University from January 2004 to March 2012. Clinical behaviors, therapeutic strategies and outcomes of angiosarcoma were analyzed in these patients. Results Of the seven patients, four were male, and three were female, with a median age of 67 years（range, 37 － 77 years）. Clinical presentations were various, including irregular ulcerous nodular masses in four patients, localized ulcer in one patient, and irregular erythematous nodules in two patients. All the patients were treated surgically with or without postoperative adjuvant therapy. Pathological examination revealed various degrees of differentiation and atypia of tumor cells, as well as obvious proliferation of endothelial cells, and all of these patients were diagnosed as angiosarcoma. Immunohistochemical analysis revealed a positive staining for CD31 and CD34. After surgical treatment, angiosarcoma recurred in four patients with the median time to the first recurrence being 3.5 months （range, 1 － 6 months）, cerebral metastasis occurred in one patient 5 months later, and two patients died. Conclusions Angiosarcoma is a rare and heterogeneous sarcoma with diverse clinical presentations. Local wide resection is the cornerstone of angiosarcoma treatment, and adjuvant therapy may improve its prognosis.