Radiation-Associated Angiosarcoma as a Presentation of Disease Progression in a Patient on Immunotherapy for Metastatic Non-small Cell Lung Cancer.

放射相关血管肉瘤作为转移性非小细胞肺癌免疫治疗患者疾病进展的表现。

• 发表时间: 2023 Sep
• 来源期刊: Cureus
• DOI: 10.7759/cureus.44724
• PMID: 37809227
• 文章类型: Case Reports
• 作者列表: Tan H,Torere BE,Okun S,Hinton B

关键词: adenocarcinoma of the lung; epithelioid angiosarcoma; metastatic non-small cell lung cancer; nccn guidelines; non-small cell lung carcinoma (nsclc); radiation-associated cancer; secondary primary cancer; stage iv nsclc

Abstract

Non-small cell lung cancer (NSCLC) is the dominant form of lung cancer, comprising around 85% of cases. Stage 4 NSCLC has a grim prognosis; however, immunotherapy and radiation therapy have become vital treatments for advanced-stage NSCLC, despite the risk of inducing a second primary malignancy. This case report focuses on a 45-year-old female diagnosed with NSCLC and metastasis to the 11th thoracic vertebral body. After various treatments, including radiation, a potential radiation-associated secondary malignancy, epithelial angiosarcoma, was discovered. Following treatment modification, the patient achieved complete metabolic remission, highlighting the importance of clinicians being cautious about secondary primary cancers in NSCLC patients with a history of radiation therapy. Accurate diagnosis through biopsy and continuous surveillance are essential in managing NSCLC patients effectively.

摘要

非小细胞肺癌（NSCLC）是肺癌的主要形式，约占85%的病例。4期非小细胞肺癌预后严峻；然而，免疫治疗和放射治疗已成为晚期非小细胞肺癌的重要治疗方法，尽管有诱发第二原发性恶性肿瘤的风险。该病例报告集中于一名45岁的女性，诊断为NSCLC并转移至第11胸椎体。经过各种处理,包括辐射,潜在的辐射相关继发性恶性肿瘤,上皮性血管肉瘤,被发现了。在处理修改后,患者实现了完全的代谢缓解，强调在有放射治疗史的NSCLC患者中,临床医师对继发性原发癌保持谨慎的重要性.通过活检和连续监测的准确诊断对于有效管理NSCLC患者至关重要。