Chalazion-mimicked eyelid angiosarcoma in a young Asian with good prognosis: a case report.
Angiosarcoma
Chalazion
Eyelid
Misdiagnosis
Surgical excision
Journal
BMC ophthalmology
ISSN: 1471-2415
Titre abrégé: BMC Ophthalmol
Pays: England
ID NLM: 100967802
Informations de publication
Date de publication:
02 Jan 2024
02 Jan 2024
Historique:
received:
11
06
2023
accepted:
11
12
2023
medline:
4
1
2024
pubmed:
4
1
2024
entrez:
3
1
2024
Statut:
epublish
Résumé
Angiosarcoma is an extremely rare malignant tumor. So far, only about 42 cases of angiosarcoma involving the eyelids have been reported. Eyelid angiosarcoma occurs more frequently in elderly Caucasian males and is prone to misdiagnosis. We present a case report in a young Asian male patient with eyelid angiosarcoma that was misdiagnosed as a chalazion. A 46-year-old South Korean male with no underlying disease had a right lower lid mass. The lesion was initially misdiagnosed as a chalazion at a local clinic, but a diagnosis of eyelid angiosarcoma was made after the first biopsy trial. PET-CT was performed to ensure that there was no metastasis in the whole body. Surgical excision with enough surgical margin was used alone for treatment and reconstruction was performed with a tarsoconjunctival advancement flap (modified Hughes procedure), which helped ensure good cosmesis. No recurrence was observed 4 years and 5 months after the surgery. The current study presents the first case of chalazion-mimicked eyelid angiosarcoma in a young Asian male aged under 50 years. This case shows that even if a benign eyelid disease is suspected in a young patient, an incisional biopsy must be performed to confirm whether the lesion is malignant. Since the prognosis is good for the case of eyelid angiosarcoma, if there is no clear evidence of distal metastasis, surgical resection should be performed with an enough safety margin.
Sections du résumé
BACKGROUND
BACKGROUND
Angiosarcoma is an extremely rare malignant tumor. So far, only about 42 cases of angiosarcoma involving the eyelids have been reported. Eyelid angiosarcoma occurs more frequently in elderly Caucasian males and is prone to misdiagnosis. We present a case report in a young Asian male patient with eyelid angiosarcoma that was misdiagnosed as a chalazion.
CASE PRESENTATION
METHODS
A 46-year-old South Korean male with no underlying disease had a right lower lid mass. The lesion was initially misdiagnosed as a chalazion at a local clinic, but a diagnosis of eyelid angiosarcoma was made after the first biopsy trial. PET-CT was performed to ensure that there was no metastasis in the whole body. Surgical excision with enough surgical margin was used alone for treatment and reconstruction was performed with a tarsoconjunctival advancement flap (modified Hughes procedure), which helped ensure good cosmesis. No recurrence was observed 4 years and 5 months after the surgery.
CONCLUSIONS
CONCLUSIONS
The current study presents the first case of chalazion-mimicked eyelid angiosarcoma in a young Asian male aged under 50 years. This case shows that even if a benign eyelid disease is suspected in a young patient, an incisional biopsy must be performed to confirm whether the lesion is malignant. Since the prognosis is good for the case of eyelid angiosarcoma, if there is no clear evidence of distal metastasis, surgical resection should be performed with an enough safety margin.
Identifiants
pubmed: 38166705
doi: 10.1186/s12886-023-03262-z
pii: 10.1186/s12886-023-03262-z
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1Informations de copyright
© 2023. The Author(s).
Références
Mark RJ, Poen JC, Tran LM, Fu YS, Juillard GF. Angiosarcoma. A report of 67 patients and a review of the literature. Cancer. 1996;77:2400–6.
doi: 10.1002/(SICI)1097-0142(19960601)77:11<2400::AID-CNCR32>3.0.CO;2-Z
pubmed: 8635113
Young RJ, Brown NJ, Reed MW, Hughes D, Woll PJ. Angiosarcoma Lancet Oncol. 2010;11:983–91.
doi: 10.1016/S1470-2045(10)70023-1
pubmed: 20537949
Hwang G, Shin J, Lee JY, Na KS, Paik JS, Yim HW, et al. The Eyelid Angiosarcoma: a systematic review of characteristics and clinical course. J Clin Med. 2022;11:4204.
doi: 10.3390/jcm11144204
pubmed: 35887967
pmcid: 9320659
Holden CA, Spittle MF, Jones EW. Angiosarcoma of the face and scalp, prognosis and treatment. Cancer. 1987;59:1046–57.
doi: 10.1002/1097-0142(19870301)59:5<1046::AID-CNCR2820590533>3.0.CO;2-6
pubmed: 3815265
Alsammahi A, Aljohani Z, Jaad N, Abu Daia O, Aldayhum M, Almutairi M, et al. Incidence and predisposing factors of chalazion. Int J Community Med Public Health. 2018;5:4979–82.
doi: 10.18203/2394-6040.ijcmph20184253
Bajaj S, Sharma PK, Sachdev IS, Bhardhwaj M. A novel presentation of cutaneous angiosarcoma: a case report and review. Indian J Med Paediatr Oncol. 2017;38:363–6.
doi: 10.4103/ijmpo.ijmpo_81_16
pubmed: 29200692
pmcid: 5686985
Shustef E, Kazlouskaya V, Prieto VG, Ivan D, Aung PP. Cutaneous angiosarcoma: a current update. J Clin Pathol. 2017;70:917–25.
doi: 10.1136/jclinpath-2017-204601
pubmed: 28916596
Hart J, Mandavilli S. Epithelioid angiosarcoma: a brief diagnostic review and differential diagnosis. Arch Pathol Lab Med. 2011;135:268–72.
doi: 10.5858/135.2.268
pubmed: 21284449
Shin SJ, Lesser M, Rosen PP. Hemangiomas and angiosarcomas of the breast: diagnostic utility of cell cycle markers with emphasis on Ki-67. Arch Pathol Lab Med. 2007;131:538–44.
doi: 10.5858/2007-131-538-HAAOTB
pubmed: 17425381
Al-Abbadi MA, Almasri NM, Al-Quran S, Wilkinson EJ. Cytokeratin and epithelial membrane antigen expression in angiosarcomas: an immunohistochemical study of 33 cases. Arch Pathol Lab Med. 2007;131:288–92.
doi: 10.5858/2007-131-288-CAEMAE
pubmed: 17284115
Sullivan HC, Edgar MA, Cohen C, Kovach CK, HooKim K, Reid MD. The utility of ERG, CD31 and CD34 in the cytological diagnosis of angiosarcoma: an analysis of 25 cases. J Clin Pathol. 2015;68(1):44–50.
doi: 10.1136/jclinpath-2014-202629
pubmed: 25352641
McKay KM, Doyle LA, Lazar AJ, Hornick JL. Expression of ERG, an ets family transcription factor, distinguishes cutaneous angiosarcoma from histological mimics. Histopathology. 2012;61(5):989–91.
doi: 10.1111/j.1365-2559.2012.04286.x
pubmed: 22716285
Miettinen M, Wang ZF, Paetau A, Tan SH, Dobi A, Srivastava S, et al. ERG transcription factor as an immunohistochemical marker for vascular endothelial tumors and prostatic carcinoma. Am J Surg Pathol. 2011;35(3):432–41.
doi: 10.1097/PAS.0b013e318206b67b
pubmed: 21317715
pmcid: 6880747
Zollino I, Riberti C, Candiani M, Candotto V, Carinci F. Eyelid reconstruction following excision of cutaneous malignancy. J Craniofac Surg. 2014;25:e13–7.
doi: 10.1097/SCS.0b013e3182a2ed04
pubmed: 24406600
Alghoul M, Pacella SJ, McClellan WT, Codner MA. Eyelid reconstruction. Plast Reconstr Surg. 2013;132:288e–302e.
doi: 10.1097/PRS.0b013e3182958e6b
pubmed: 23897357