No abstract

We report the case of a 45-year-old woman with a slow-growing palpable nodule on the left breast, confirmed as a well-defined opacity on mammography, corresponding to a 5 cm hyperechoic lesion on ultrasound, and considered, on the basis of clinical examination and radiological findings, to be consistent with a lipoma. One year later, the patient represented with an enlarged left breast mass and underwent further imaging investigation with subsequent diagnosis of primary breast angiosarcoma obtained via a Vacuum-Assisted Breast Biopsy. The patient developed metastatic disease and succumbed to the disease one year after definitive diagnosis. Primary breast angiosarcoma is a rare malignant vascular neoplasia, characterized by aggressive patterns, poor prognosis, and absence of pathognomonic radiological features. Currently, there are no evidence-based guidelines regarding treatment, even though wide surgical resection followed by chemo- and radiotherapy appears to improve survival.

SUMMARY  Malignant pleural mesothelioma (MPM) is an aggressive tumor of pleural membranes with a dismal prognosis. Following diagnosis survival is usually less than 12 months. The treatment is therefore very often palliative. In selected cases with early stage disease surgical resection is possible. Several studies have now shown that combination treatment with chemotherapy (CHT), radiotherapy (RT) and radical surgery lead to an increased overall survival (OS). This review analyzes the long-term results of the two different types of radical surgery included in the multimodality treatment: extrapleural pneumonectomy (EPP) and pleurectomy/decortication (P/D). Recent studies have shown P/D to have less morbidity with comparable or better OS compared with EPP while enabling more patients to complete multimodality treatment.