Therapeutic efficacy of interferon alfa-2a and 13-cis-retinoic acid in recurrent angiosarcoma of the head.

A 77-year-old male patient presented with a 2-year history of recurrent angiosarcoma (AS) of the face and scalp. At the time of initial diagnosis, multifocal growth of the tumor was visible. On the left side of the scalp and forehead, several 1to 5-cm reddish-brown nodules were noticed, one of which was ulcerated and hemorrhagic. Another 5-cm plaquelike lesion was seen on the left cheek. The presumptive diagnosis of AS was confirmed by histological analysis. X-ray examination of skull and chest, magnetic resonance imaging of the neck, and abdominal ultrasound revealed no evidence of local or distant metastases. Due to the extent of the disease, radical surgery was not an appropriate option. It was thus decided to treat the AS by field electron beam therapy (cheek, 56 Gy; scalp and forehead, each 60 Gy; 2 Gy per fraction), leading to a complete response. Three months after electron beam therapy had been completed, a local recurrence developed in the nonirradiated frontoparietal region. Likewise, this area was successfully treated by field electron beam therapy (60 Gy; 2 Gy per fraction). Six months later, an apparent relapse of the tumor was observed in the electron beam–irradiated field (Figure 1). Examination showed a flat, sharply defined, 30-cm duskyred plaque involving the left tragus and preauricular region. Biopsy specimens taken from the cheek revealed typical histological findings of AS (Figure 2). No evidence of metastases in repeated staging procedures was observed.