What is the clinical evidence from this study?

Study design: Case Report. Population: Primary posterior mediastinal epithelioid angiosarcoma (n=1). Intervention: Systemic paclitaxel and intrapleural cisplatin. Primary outcome: Survival and disease control.

What question did this study set out to answer?

The aim is to report a rare case of epithelioid angiosarcoma and the effectiveness of multimodal salvage therapy after recurrence.

April 27, 2026Journal of Cardiothoracic SurgeryOpen Access

Primary posterior mediastinal epithelioid angiosarcoma presenting as epigastric pain: long-term survival achieved via multimodal salvage therapy after early recurrence

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Key result

Paclitaxel and cisplatin salvage therapy yields >20 months survival in a relapsing mediastinal angiosarcoma case.

Why the study?

Does a multimodal salvage regimen of systemic paclitaxel and intrapleural cisplatin improve survival in a patient with recurrent primary posterior mediastinal epithelioid angiosarcoma?

Key Points

The aim is to report a rare case of epithelioid angiosarcoma and the effectiveness of multimodal salvage therapy after recurrence.
Patient underwent video-assisted thoracoscopic surgery for tumor resection.
Systemic paclitaxel and intrapleural cisplatin were administered after local recurrence.
Follow-up assessed clinical response and quality of life for over 20 months.
Post-therapy, the patient experienced resolution of pleural effusion.
Sustained disease control was achieved with treatment.
The patient maintained a good quality of life for over 20 months after recurrence.

Study Design

Type

Case Report (n=1)

Multicenter

Structured PICO

Does a multimodal salvage regimen of systemic paclitaxel and intrapleural cisplatin improve survival in a patient with recurrent primary posterior mediastinal epithelioid angiosarcoma?

Population

1 68-year-old male with primary posterior mediastinal epithelioid angiosarcoma (EA) presenting with atypical upper abdominal pain, who experienced early recurrence with symptomatic hemorrhagic pleural effusion within one month of macroscopic complete resection via VATS.

Intervention

Multimodal salvage regimen consisting of systemic paclitaxel (80 mg/m² intravenously on days 1, 8, 15 every 4 weeks, six cycles) and intrapleural cisplatin instillation (40 mg weekly for two doses).

Outcome

Survival and disease control (resolution of pleural effusion and sustained disease control)hard clinical

Intensive multimodal therapy combining systemic paclitaxel and intrapleural cisplatin can achieve long-term survival and durable disease control in rapidly recurrent mediastinal epithelioid angiosarcoma.

Limitations

Single-case study, limiting broad generalizability.
Standard preoperative PET-CT and formal R0/R1 margin assessments were not performed due to initial clinical misdiagnosis.
Detailed molecular testing (e.g., MYC amplification) was not performed.
Targeted agents or immunotherapy were not utilized.
Single-case study
PET-CT and formal R0/R1 margin assessments were not performed initially due to clinical misdiagnosis
Lack of detailed molecular testing (e.g., MYC amplification)

Discussion

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Implication

VATS achieved complete resection of unsuspected posterior mediastinal epithelioid angiosarcoma; leaves open optimal adjuvant therapy and surveillance.

Cite This Study

Xiao et al. (2026) conducted a case report in Primary posterior mediastinal epithelioid angiosarcoma (n=1). Systemic paclitaxel and intrapleural cisplatin was evaluated on Survival and disease control. Multimodal salvage therapy with systemic paclitaxel and intrapleural cisplatin achieved survival beyond 20 months in a patient with early-relapsing mediastinal epithelioid angiosarcoma.

synapsesocial.com/papers/69eefc6dfede9185760d369b https://doi.org/10.1186/s13019-026-04130-9

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Implication

VATS achieved complete resection of unsuspected posterior mediastinal epithelioid angiosarcoma; leaves open optimal adjuvant therapy and surveillance.

Primary posterior mediastinal epithelioid angiosarcoma presenting as epigastric pain: long-term survival achieved via multimodal salvage therapy after early recurrence

Key Points

Study Design

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Primary posterior mediastinal epithelioid angiosarcoma presenting as epigastric pain: long-term survival achieved via multimodal salvage therapy after early recurrence

Key Points

Study Design

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Also Consider

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