Friday, January 18th, 2019


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Brachytherapy-Associated Angiosarcoma of the Bladder-Prostate with Splenic Metastasis: A Case Report
Authors:  Raúl Rodríguez-Aguilar, M.D., Ph.D., Diana Rodríguez-Villar, M.D., Rebeca Blanco-Fernández, M.D., María Poch-Arenas, M.D., Sergio Fernández-Pello Montes, M.D., and José Salgado-Plonski, M.D.
  BACKGROUND: Primary angiosarcomas from the bladder and/or prostate are rare. Due to the more frequent diagnosis of prostate cancer and management with radiotherapy, its incidence is increasing. CASE: We report a case of high-grade angiosarcoma in that location in an 81-year-old man with history of prostatic adenocarcinoma, treated with brachytherapy 6 years previously. He consulted for acute renal insufficiency, and a great and diffuse irregular thickening of his bladder walls was found, obstructing ureteral orifices and causing hydronephrosis. Diffuse MYC overexpression in the tumor cells supported the diagnosis of radiation-associated angiosarcoma. Several splenic nodules were discovered then. A transurethral biopsy of the bladder lesion showed a high-grade angiosarcoma with a predominant spindle cell pattern. A needle biopsy from one solid splenic nodule showed the same microscopy.
Bladder/prostate angiosarcoma is a rare entity with a poor prognosis. Its incidence is increasing due to widespread PSA prostate cancer screening and more frequent low-grade prostatic cancer detection being treated with radiotherapy.
Keywords:  angiosarcoma, brachytherapy, MYC, prostatic diseases, prostatic neoplasms, radiation-induced neoplasms, radiotherapy, urinary bladder neoplasms, urogenital neoplasms
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