DEC 06, 2016

Diagnosed: Agent Orange is the Culprit Behind Rare Sarcoma

WRITTEN BY: Xuan Pham
In a new case report, doctors suspect Agent Orange as the cause of a rare type of soft tissue cancer known as pleomorphic liposarcoma.

Agent Orange is the infamous warfare herbicide that was doused in Southeast Asia during the Vietnam War. It was so-called “Agent Orange” due to orange-striped 55-gallon drums that were used to store the chemicals. The compounds – a mixture of 2,4-dichlorophenoxyacetic acid (2,4-D) and 2,4,5-trichlorophenoxyacetic acid (2,4,5-T) - acted to strip leaves from trees and plants. By destroying the crops, bushes, and trees, this defoliant served as a powerful wartime weapon.

However, the toxicity of Agent Orange carried over to human health too. The nearly 20 million gallons of chemicals sprayed in Vietnam, Laos, and Cambodia are linked to a multitude of health problems. These range from stillbirths, to birth defects like cleft palate, spina bifida, and other neural tube defects, and mental disability. It’s estimated that millions of Vietnamese people became victims of Agent Orange.
 

And the list of victims also includes the American soldiers who served in Vietnam during the 1960s and 1970s. While cancer risks from Agent Orange has been strongly suspected for a long time, the current case report marks the first time the defoliant is linked to pleomorphic liposarcoma.

Pleomorphic liposarcoma is a cancer that arise from soft tissues, like fat, joints, or muscles. The name pleomorphic refers to the multi-shape appearance of the cancer cells under the microscope. While soft tissue sarcomas are rare, pleomorphic liposarcoma are even rarer. However, the cancer is extremely fast-growing and has a penchant for spreading and recurring. As such, it is notoriously difficult to treat.

The patient, a 69-year-old Vietnam War veteran, was exposed to Agent Orange from his years of service in an area sprayed with the herbicide. Upon examination, doctors found an enlarged mass in his right thigh. This was accompanied by reports of a bout of year long pain. A tissue biopsy confirmed the diagnosis of pleomorphic liposarcoma.

"There has been no well-established precipitating factor for liposarcomas," the doctors wrote. "However, clinicians should have a high degree of suspicion for persistent and evolving soft tissue masses, especially in patients with a previous military background. This should prompt the search for a possible toxin exposure." In other words, Agent Orange seemed to be the smoking gun for this seemingly rare type of cancer.
 

This case is a reminder of how little we understand about the health effects of Agent Orange, and how the ramifications are still being felt decades after the event has passed.

"The patient was educated about his diagnosis and was counselled about the unfortunate side effects with which Agent Orange has been associated. He continues to be monitored for disease recurrence and will continue to do so for years,” the doctors wrote.

Additional sources: EurekAlert!