Phenol application to angiosarcomas: implications and histologic studies.
BACKGROUND
Cutaneous angiosarcoma (AS) is an aggressive endothelial sarcoma that arises in elderly people. Effective treatment options are limited. Phenol application has been reported to be effective and economical.


OBJECTIVE
To evaluate the efficacy of phenol application for the treatment of AS, and to examine the histologic changes in three cases of cutaneous AS with phenol application.


METHODS
After phenol application, biopsy specimens were collected from three patients with cutaneous AS. Paraffin-embedded sections of the skin specimens were then stained with hematoxylin and eosin. The detection of apoptosis was performed using the terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate-digoxigenin nick end labeling (TUNEL) method, and the depth of TUNEL-positive cell staining was examined.


RESULTS
Phenol treatment induced a strong degeneration of tumor cells and endothelial cells in the dermis, when compared with nontreated areas. Positive staining of tumor cells and/or endothelial cells by the TUNEL method was found in phenol-treated lesions, but not in nontreated lesions. The injurious effects on these tumor cells persisted for as long as 6 h after phenol application.


CONCLUSIONS
From a comparison of noninvasive therapy with standard surgical therapy, it is obvious that phenol peeling has several advantages with regard to the ease of the procedure, time efficiency, no need for special equipment, low therapeutic costs, good pain control, and post-treatment follow-up. This study suggests that phenol application can be a supportive treatment for AS.
Department of Dermatology, Wakayama Medical University, Wakayama, Japan. kamikami@wakayama-med.ac.jp
Chikako
C
Kaminaka
Yuki
Y
Yamamoto
Nozomi
N
Yonei
Fukumi
F
Furukawa
D000368:Aged; D000369:Aged, 80 and over; D017209:Apoptosis / Q000187:drug effects; D001706:Biopsy; D005260:Female; D006394:Hemangiosarcoma / Q000188:drug therapy* / Q000473:pathology*; D006801:Humans; D020287:In Situ Nick-End Labeling; D019800:Phenol / Q000627:therapeutic use*; D012597:Sclerosing Solutions / Q000627:therapeutic use*; D012867:Skin / Q000473:pathology; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000473:pathology*
D012597:Sclerosing Solutions; D019800:Phenol