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.
|Eyelid||Eyelid and other structures||Wilson-Jones Angiosarcoma (Holden 1987)|
|number of patients||12||28||74|
|clinical||50% nodular||varriable||bruise-like macule|
|survival||100% at 3.2 years||43% dead at 3.3 years||50% died in 15 months|
|treatment||excision||68% surgery, 32% non-surgical||radiation|
|Size||2.08 cm||5.0 cm||varriable|