Unresectable angiosarcoma of the head and neck: A case report highlighting genomic alterations, targeted therapy, and clinical response
Angiosarcoma of the head and neck is an aggressive malignancy with limited therapeutic options when unresectable. We report the case of a 73-year-old male with advanced scalp and neck angiosarcoma characterized by MYC amplification and high tumor mutational burden. He received a multimodal treatment strategy including dual immune checkpoint blockade (nivolumab and ipilimumab) combined with cabozantinib, followed by paclitaxel and subsequent pazopanib. This approach achieved prolonged disease control exceeding 18 months, with manageable toxicities through dose adjustments and supportive care. Genomic profiling guided therapeutic decisions and highlighted the role of MYC amplification and tumor mutational burden as potential biomarkers for treatment response. This case emphasizes the importance of molecular characterization in guiding precision oncology for rare sarcomas and demonstrates the clinical utility of combining immunotherapy with antiangiogenic agents in the management of unresectable angiosarcoma.
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