Atypical presentation of angiosarcoma of the scalp in the setting of Human Immunodeficiency Virus (HIV)
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BioMed Central
Open Access
Case report
Atypical presentation of angiosarcoma of the scalp in the setting of Human Immunodeficiency Virus (HIV) Poovandren S Govender Address: Department of Radiotherapy and Oncology, Nelson R. Mandela School of Medicine, University of Kwazulu Natal, Durban, South Africa Email: Poovandren S Govender - [email protected]
Published: 18 December 2009 World Journal of Surgical Oncology 2009, 7:99
doi:10.1186/1477-7819-7-99
Received: 31 October 2009 Accepted: 18 December 2009
This article is available from: http://www.wjso.com/content/7/1/99 © 2009 Govender; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: Angiosarcoma of the head and neck is an uncommon, aggressive malignant entity most commonly found in elderly Caucasian males. We present a case in a young black female with co-existing HIV. The atypical gender, age and race of the patient reflect the unusual clinical presentation of this case of angiosarcoma, attributable to the patient's HIV status. Case presentation: A 22 year old patient presented with a large unresectable lesion over the occiput with surrounding ulceration, satellite lesions and associated lymphadenopathy. She is HIVinfected with a CD4 count of 360 cells/μl. She was not on antiretroviral treatment based on South African treatment guidelines advocating antiretroviral treatment when the CD4 count is below 200 cells/μl, in the absence of other AIDS-defining illnesses. The patient was treated with a course of ifosfamide and anthracyline based chemotherapy. Disease progression was noted on chemotherapy and she was subsequently palliated with a course of radiotherapy. She had a satisfactory response with an improvement in local symptoms. She is currently receiving symptomatic care. Conclusions: South Africa is at the epicenter of the HIV epidemic. Consequently, the management of patients in the field of oncology in our clinical practice is often burdened with malignancies manifesting with an atypical disease presentation and clinical course.
Background Angiosarcoma of the head and neck is an uncommon aggressive cancer of the skin and soft tissues [1]. These malignancies are most commonly found in Caucasians and are 3-4 times more common in males than females with a median age of 61 to 67 years [2,3]. We report an atypical presentation of a case of angiosarcoma of the scalp occurring in association with HIV in a 22 year old black female. Linkage studies of population-based registries involving people with HIV/AIDS and cancer have shown a statisti-
cally significant increase in the incidence and relative risk of many Non-AIDS Defining Cancers (NADCs). Tumours displaying unusual features and aggressive behaviour patterns in young individuals should alert physicians to the possibility of underlyi
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