Open AccessThe role of c-MYC expression in the diagnostic and clinical confirmation of radiation-induced angiosarcoma
Author(s) -
Luka Jovanović,
Predrag Filipović,
Jelena Dedovic-Stojakovic,
Zorka Milovanović,
Milica LabudovićBorović,
Jasminka Tanasijevic,
Predrag Petrašinovic,
Tamara Marinkovic,
Vesna Plešinac-Karapandžić
Publication year - 2022
Publication title -
vojnosanitetski pregled
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.123
H-Index - 19
eISSN - 2406-0720
pISSN - 0042-8450
DOI - 10.2298/vsp201207028j
Subject(s) - medicine , radiation therapy , angiosarcoma , immunohistochemistry , cd34 , endometrial cancer , chemotherapy , cancer , pathology , radiology , surgery , biology , genetics , stem cell
Introduction. Angiosarcomas (AS) arising from vascular tissue, accounting for 3.3% of all sarcomas, have a poor prognosis. Radiation-induced AS is a rare late complication of radiotherapy treatment and is characterized by a gene expression profile such as amplification of the MYC oncogene, by which we can distinguish primary from the secondary induced tumor. Case report, At 77-year-old patient, with early-stage endometrial adenocarcinoma, the radical hysterectomy with bilateral salpingo-oophorectomy was initially done. According to pathological risk factors, the postoperative external beam conformal radiotherapy (CRT) of the pelvis was administered with concomitant brachytherapy. Six years after the treatment, on the anterior abdominal wall, in the region of the postoperative irradiation field and surgical scar, an infiltrative angiosarcoma of the skin and subcutaneous adipose tissue, was histologically confirmed. The patient received six cycles of mono-Adriamycin chemotherapy with verified partial regression. Additional immunohistochemical analysis (IHH) of c-MYC, Ki67 and CD34 expression showed a high proliferative index (Ki67 around 60%) and c-MYC positivity indicating the molecular pattern of radiation-induced AS. Furthermore, the high proliferative index could explain a good response to chemotherapy. Conclusion. The novel postoperative radiotherapy techniques provide better survival and local control in risk- endometrial cancer groups with a decrease of irradiation complications. These patients with longer survival, are in a higher risk of developing radiation-induced tumours as late side-effects of radiotherapy. When assessing the probability of radiation-induced AS, IHH analysis of c-MYC expression could distinguish secondary from others AS if Cahan?s criteria are fulfilled.