Pulmonary Fibrosis after Pegylated Liposomal Doxorubicin inElderly Patient with Cutaneous Angiosarcoma

Angiosarcoma is a rare cancer of the inner lining of blood vessels and can arise anywhere in the body, most commonlypresenting as cutaneous disease in elderly patient, involving head and neck (H&N), especially the scalp. Pegylated liposomaldoxorubicin (PLD) is one of the available treatments in patients with advanced or metastatic disease. Common toxicities aremyelosuppression, palmar-plantar erythrodysesthesia, nausea, and stomatitis. Regarding PLD-related pulmonary fibrosis in anuncommon toxicity, there are few cases reported in literature. None of these occurred in angiosarcoma.Methods. This is a casereport describing an elderly patient treated with PLD for advanced H&N cutaneous angiosarcoma who developed G5 pulmonarytoxicity after the second PLD administration.Results. According to our data and patient clinical outcome, we believe that she passedaway from fatal PLD-induced pulmonary fibrosis. This is the first case of fatal interstitial pneumonitis in a 77-year-old womantreated with PLD for angiosarcoma. The case has been reported for its rarity.Conclusions. Pathophysiology of this phenomenon isstill unclear and more studies are necessary to understand the true incidence of pulmonary toxicities in patients in treatments withPLD and its mechanism.