Unusual presentation of metastatic radiogenic breast angiosarcoma

A 56-year-old woman underwent quadrantectomy with axillary dissection followed by adjuvant radiotherapy (RT) with 30  Gy for a mucinous carcinoma of the left breast (T1cN0M0). Because oestrogen and progesteron receptors were positive, she was given antihormonal therapy for 5 years. Nine years later, the patient underwent local excision of a 0.7 × 0.8 cm pigmented papule skin lesion of the operated breast. Hist ology revealed high-grade angiosarcoma (Fig. 1a), and immunohistochemistry was positive for CD31 (Fig. 1b) and CD34, whereas c-myc amplification was negative at fluorencein situ hybridization (FISH). Because of the history of previous RT and the typical appearance of the lesion, the tumour was presumably considered radiogenic. No residual disease was found after simple mastectomy, and adjuvant treatment was not administered. A positron emission tomography/computed tomography (PET/CT) scan performed 1  year later showed ill-defined hypermetabolism in the mediastinal lymph nodes (SUV max 11) (Fig. 2A). Video assisted thoracoscopy biopsy revealed recurrence from angiosarcoma, and she was given taxane-based chemotherapy for 6  months with complete remission. A 7.6 × 6.8 cm rounded mass in the right adrenal with heterogeneous contrast enhancement was seen 5 years later at surveillance up CT, without enlarged regional lymph nodes or other metastatic diseases (Fig. 2B). At admission, physical examination and laboratory tests including biochemical work-up were unremark...
Source: Japanese Journal of Clinical Oncology - Category: Cancer & Oncology Source Type: research