[1710] Angiosarcoma of the Eyelid: A Clinicopathologic Comparison between Isolated Unilateral Eyelid Tumors and Tumors Demonstrating Extra-Palpebral Involvement

JA Papalas, CK Manavi, OP Sangueza, TJ Cummings. Duke University Medical Center, Durham, NC; Wake Forest University School of Medicine, Winston-Salem, NC

Background: Angiosarcomas of the head and neck tend to involve numerous anatomical structures with an overall dismal prognosis. Reports of primary isolated eyelid involvement are rare.
Design: We report 4 cases of angiosarcoma involving the eyelid as either an isolated tumor or as part of a more diffuse malignant process and compare the features of these two tumor types to cases described in the literature.
Results: Overall average age at which patients develop angiosarcoma involving the eyelid was 72. Patients with isolated tumors most often presented complaining of a discrete mass clinically resembling a stye. Patients with isolated eyelid involvement had better survival with no patients dying (average followup 1.5 years) compared to patients with more diffuse disease. When comparing our patients to those reported in the literature, isolated eyelid involvement arises rapidly, with an average tumor size of 2.08 cm. 25% of tumors are misdiagnosed. No patients develop metastasis and 100% are alive after an average period of 3.2 years. With optimal management, tumor progression after treatment is rare. Patients who have eyelid angiosarcoma with extra-palpebral involvement have tumors ranging between 5-10 cm. 21% of patients develop metastasis. Regardless of the treatment, 68% of these patients develop disease progression and 43% were dead after 3.3 years.

Clinicopathologic comparison of patients with angiosarcoma involving just the eyelid versus patients with tumors involving the eyelid and other structures
EyelidEyelid and other structuresWilson-Jones Angiosarcoma (Holden 1987)
number of patients122874
presentationrapidvarriablescalp/face
clinical50% nodularvarriablebruise-like macule
ulceration0%rarely14%
misdiagnosed25%rarelyrarely
metastasis0%21%23%
survival100% at 3.2 years43% dead at 3.3 years50% died in 15 months
regression1/160%1/72
treatmentexcision68% surgery, 32% non-surgicalradiation
progressionrare68%frequent
Size2.08 cm5.0 cmvarriable



Conclusions: Patients with isolated eyelid angiosarcoma present at similar ages to patients with more extensive disease, their tumors rarely progress outward to involve extra-palpebral structures, and they do better with more conservative surgical-oncogical management when compared to patients with eyelid involvement secondary to more extensive face disease.
Category: Ophthalmic

Wednesday, March 24, 2010 1:00 PM

Poster Session VI # 260, Wednesday Afternoon

 

Close Window