Unexpected death due to spontaneous splenic rupture: A rare case in splenic angiosarcoma.

Introduction: Spleen angiosarcoma (SA) is a rare malignant neoplasm that arises from the splenic vascular endothelium, with only around 300 cases reported to date. Due to a limited number of reported cases, there is a paucity of data and a lack of understanding of its presentation, diagnosis, and management. In this study, we aim to provide a comprehensive review of SA.Areas covered: On 27 February 2021, a literature search was done in PubMed and Embase database. The search yielded 122 articles involving 205 patients. The focus was on patient demographics, risk factors, clinical presentations, investigation results, preliminary diagnoses, therapies provided, and patient outcomes. These factors were analyzed to identify possible risk factors, diagnostic modalities, and therapeutic principles that were not mentioned before.Expert opinion: The clinical presentation or investigation results of patients with SA are often nonspecific. Hence, they may not be sufficient to clinch the diagnosis of SA if used alone. The authors recommend a triple assessment of clinical examination, imaging findings, and pathology to diagnose SA with high accuracy. Splenectomy should be the mainstay of management, with chemotherapy and radiotherapy considered as adjuncts, especially in the presence of metastases.

Spleen angiosarcoma: a world review

ABSTRACT Primary splenic or hepatic angiosarcomas are ultra-rare and aggressive malignancies associated with poor prognosis. The mainstay treatments are surgical resection and chemotherapy. We report a case of angiosarcoma in a 50-year-old woman who presented with bruising, fatigue, ecchymosis, and hepatosplenomegaly. She was treated with the multi-kinase inhibitor sunitinib for 4 weeks before developing a splenic hemorrhage and succumbing. Recent studies have demonstrated the clinical benefit of immunotherapies in angiosarcomas. Additionally, sequencing techniques have showcased the diverse molecular aberrations involved in angiosarcomas, which offer opportunities for precision-matched targeted therapies such as inhibitors of the VEGF/VEGFR axis and PI3K/Akt/mTor pathway. 

Images in Immunotherapy and Precision Oncology: Angiosarcoma of the Spleen and Liver

Hepatocellular carcinoma (HCC) is one of the most common and fatal malignancy in humans and proves to be the third most common cause of cancer-related death. Thus, HCC contributes to major international health problem because its incidence is exponentially increasing in many countries. One of the main reasons for the lethality of HCC is the lack of diagnostic markers for early detection of the disease. At late stages, HCC shows a high clinical heterogeneity with poor prognosis i.e. high tumor recurrence is observed in 60-70% of cases within 5 years after surgery. One of the major reasons is that most patients with HCC were diagnosed at advanced stages. It is crucial to find out new therapeutic targets and novel diagnostic biomarkers for the early diagnosis and timely treatment of HCC and to develop preventive strategies and therapeutic interventions based on an improved understanding of molecular hepato carcinogenesis. Therefore, it is still urgent to further explore the exact molecular mechanisms of the development, progression, invasion, and metastasis of HCC. It has been shown that both genetic and epigenetic alterations are crucial for the initiation of HCC, thus making epigenetics a promising and attractive field for identifying the subset of patients at a high risk of recurrence and with dismal survival outcomes.However, the underlying molecular mechanisms remain unknown. Thus, it is urgent and important to dig the hub molecules and to uncover the key molecular mechanisms. Due to the advances made in research based on next generation sequencers, it is now possible to detect and analyse epigenetic abnormalities associated with cancer. In this review article we are trying to explore previously reported to play key role in HCC development and progression such as, DNA methylation, various histone modifications, chromatin remodelling, and non-coding RNA associated gene silencing are considered to be transcriptional regulatory mechanisms associated with gene expression changes.

/pdf/genomic-epigenomic-and-proteomic-landscaping-of-3rc31ns5.pdf

Genomic, epigenomic and proteomic landscaping of hepatocellular carcinoma

Aberrant PTEN, PIK3CA, pMAPK, and TP53 expression in human scalp and face angiosarcoma.

A primary splenic angiosarcoma hepatic metastasis after splenectomy and its genomic alteration profile.

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A primary splenic angiosarcoma hepatic metastasis after splenectomy and its genomic alteration profile.