頭部打撲を契機に受診し，急速な経過を辿り死亡に至ったangiosarcomaの１例

抄録

Angiosarcoma is a disease with poor prognosis and frequently occurs on the head and face of older adults. Although it is a disease unfamili­ar to neurosurgeons, it is considered necessary to have knowl­edge of this disease. Herein, we report the case of an 84–year–old woman who was diagnosed with an angiosarcoma post–mortem. She initially presented with facial swelling, which had continued for 1 week after she had suffered several falls. Head computed tomography (CT) showed no obvious traumatic changes in the skull, and she was followed–up in the outpatient department. However, one month later, she was transported with anorexia. A wide range of subcutaneous hematomas and contusions in the right facial region and oozing from the wound site were observed. Head CT showed no obvious traumatic changes, and blood tests showed anemia, undernutrition, and dehydration. The patient was then admitted to the hospital because of poor general condition. Subcutaneous swelling and anemia progressed even after hospi­talization, and trans arterial embolization of the right superficial temporal artery was performed on the third day of hospitalization. However, her anemia did not improve postoperatively and transi­tioned to disseminated intravascular coagulation (DIC) tendency. On the 6th day, a sudden drop in blood pressure and heart rate resulted in cardiac arrest. Resuscitation was unsuccessful, and she died. The diagnosis of angiosarcoma was made from the pathological autopsy. This case elucidates the importance of a quick diagnosis when swelling of the head and face is observed without any improvement.