Introduction: Angiosarcoma is a highly malignant tumor, very rare and even more so when it comes to a thyroid localization. It is characterized morphologically by its vascular differentiation and cytological polymorphism. The objective of this study is to report a case of this entity with its evolution in the postoperative period.
Observation: patient of 54-year-oldm, with no pathological history. Operated (total thyroidectomy) for compressive multihetero-nodular goitre, revealing left toto-lobar angiosarcoma. The post-operative evolution was marked by the installation of a cervical hematoma, with a greater recurrence (10 days later): 9.8 * 8.3 * 7.7 cm extending in endothoracic and infiltrating the para-vertebral space. An additional thoraco-abdominopelvic scanner was performed in search of the primary tumor, returning without abnormality. The patient was subsequently referred in oncology for additional care.
Discussion: Angiosarcoma is a malignant tumor, very rare and fatal. His thyroid localization is exceptional. His diagnosis is the site of many controversies concerning his diagnosis and treatment: angiosarcomatous origin or angiomatoid variant of anaplastic carcinoma? Some complications such as haemorrhage, thrombocytopenia and heart failure can be observed. Local recurrences are very frequent and metastases are early and frequent. His treatment is based on the administration of propranolol, corticosteroids and metronomic chemotherapy.
Conclusion: Metastasis or localization of angiosarcoma in the thyroid is possible with poor survival. Acute onset and rapid extension pose enormous difficulties to treatment.
18 - 21 May 2019
European Society of Endocrinology