脈管肉腫の1例

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An 85-year-old man presented a dome-shaped violaceous tumor of 2 cm in diameter, in the center of a palm-sized erythematous macule on his frontal scalp. This lesion was considered to be a local recurrence of a nodular lesion which had been previously excised marginally 4 months before. The primary lesion was histologically reevaluated and diagnosed as a moderately differentiated type of angiosarcoma. The intravenous and intralesional injections of recombinant interleukin-2 (rIL-2) was started at total daily doses ranging from 70 to 105 JRU, 6 days a week. The recurrent lesion disappeared 5 weeks after the initiation of the therapy and no remnant of malignant tissue was recognized in the specimen of the excisional biopsy taken after the treatment. Seven weeks after the biopsy, sacral bone metastasis was noted by sacral pain and comfirmed by CT scan. Both scalp area and metastatic bone lesion were treated by low dose irradiation combined with systemic intravenous administration of rIL-2. However, the metastatic lesion did not show any response to the therapy. Three months later the patient died of respiratory failure caused by pneumothorax and pleuritis due to the multiple lung metastases. It is suggested that the systemic rIL-2 therapy alone is not so effective to the distant metastatic lesion in spite of the remarkable curative effect of intralesional injection of rIL-2 on the primary skin lesion of angiosarcoma.