Angiosarcoma of the Forearm Definitively Treated by Hyperfractionated Irradiation

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Abstract
A case report of an angiosarcoma treated definitively with hyperfractionated irradiation is presented. Radial and ulnar aspects of the proximal forearm, wrist, and digits were diffusely involved on angiography. Hyperfractionated irradiation totaling 7,440 cGy was delivered to the entire circumference of the hand, forearm, and distal 5 cm of the arm; a confluent dry erythema without moist desquamation was observed at completion of therapy. No significant local or systemic toxicity was noted with the administration of an Adriamycin-containing adjuvant chemotherapy regimen following irradiation. Local regional control at 2 years is documented both clinically and by angiographic examination and the patient otherwise is free of disease. Function remains excellent with no lymphedema or joint fibrosis observed and grip strength of treated and untreated hands is comparable at 35 pounds. For patients refusing amputation or who are otherwise inoperable, hyperfractionated irradiation provides a therapeutic option.