What is Angiosarcoma of the Scalp?
Angiosarcoma of the scalp is a rare type of aggressive cancer that originates from the endothelial cells of the blood vessels supplying the scalp. It is a rare type of cancer that accounts for approximately 2% of all soft tissue and bone cancers and commonly affects the scalp and face in elderly age men aged 70 and older.
What is the Scalp?
The skin covering the head is known as the scalp. Angiosarcoma of the scalp is particularly challenging to treat due to its tendency to metastasize and recur. This form of cancer, which affects both the face and scalp, is associated with poor outcomes.
The 5-year survival rate varies between 10% and 35%, depending on the stage at diagnosis and the treatments used. However, early detection and a combination of therapies can slightly improve survival rates.
Disease Causes
There is no well-known cause, however certain diseases such as chronic lymphedema, previous exposure to radiation therapy, genetic mutations (false alterations in the genes), and exposure to certain risk factors such as arsenic and vinyl chloride are major risk factors in the development of scalp and face angiosarcoma. Prior exposure to radiation therapy is a cause behind the development of secondary angiosarcoma of the face and scalp.
Signs and Symptoms
Angiosarcoma typically begins as a red or purple spot on the face or scalp. As the disease progresses, the following symptoms may develop:
- Enlargement of the tumour as it spreads to nearby tissues
- Swelling (edema) in the affected area of the face or scalp
- Tumour bleeds easily
- Ulceration (erosion) of the tumour
- The cancer tends to recur and my spread throughout the skin
- Metastasis of scalp angiosarcoma to the lungs, leading to complications and a poor survival rate.
Diagnosis
Advanced imaging methods and clinical assessment are combined to diagnose angiosarcoma of the face and neck:
- For histological confirmation, a biopsy is necessary.
- Imaging tests: CT scans of the head, neck, chest and upper abdomen are used to determine the extent and spread of tumours.
- PET/CT scans to identify any metastases or recurrences.
Treatment
The medical community uses a multimodal approach to treat angiosarcoma of the face and scalp.
Surgery: Surgical removal of the cancer lesion is the main treatment option. However, complete surgical resection (complete removal of cancer lesions along with all remnants through surgery) is difficult to achieve due to ill-defined borders of the tumour, which frequently leads to the cancer’s recurrence.
Radiation Therapy: Radiation therapy is commonly used in combination with surgery to improve treatment results and lower the recurrence rate.
Chemotherapy: For metastatic (advanced cases of cancer where it has spread to the other distant parts of the body) cases of angiosarcoma of the scalp, medications such as doxorubicin and paclitaxel are used.
Follow-up: To detect recurrences early, patients should undergo close monitoring with clinical examinations every two to three months following treatment.
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