Angiosarcoma arising in recurrent phyllodes tumour

Abstract

To our knowledge, ours is the first case of intraprostatic fat described in routine diagnostic material. The existence of intraprostatic fat suggests that invasion of fat by prostatic adenocarcinoma in needle biopsies may not always represent extraprostatic extension of tumour.However, review of the literature and our personal experience suggests that the presence of intraprostatic fat is exceedingly rare and, for practical purposes, prostatic cancer invading fat should still be considered as most in keeping with extraprostatic extension and staged as pT3a.NOTE: A recent paper published subsequent to the acceptance of this manuscript has reported intraprostatic fat in 3.98% of 427 radical prostatectomy specimens. 5Sir: Primary angiosarcoma of the breast is a rare entity, although secondary angiosarcomas arising subsequent to radiotherapy, trauma and axillary clearance are relatively common. The frequency of this rare tumour is 0.04% of primary breast tumours and approximately 8% of breast sarcomas. 1 Phyllodes tumour comprises 1% of breast malignancies 2 and is not a rare neoplasm.Sarcomas arising in malignant phyllodes tumours include rhabdomyosarcoma, chondrosarcoma, osteosarcoma and liposarcoma. 3,4 Angiosarcoma arising in phyllodes tumour has not been documented so far, to the best of our knowledge, despite a rigorous search of medical literature. A case of angiosarcoma arising in a recurrent phyllodes tumour is presented.A 30-year-old lady presented with two lumps in the right breast a year previously that were excised and each was reported as fibroadenoma on histopathological examination. After 3 months, a third lump developed, which was excised and diagnosed as a benign phyllodes tumour. After another 3 months a small lump again appeared at the 12 o'clock position, which increased in size over 6 months to a size of 80 · 70 mm occupying the upper medial and lateral quadrants and subareolar region of the breast. The lump was painful but there was no nipple discharge or retraction. The patient had not received any radiotherapy in the past. On core needle biopsy, a vascular neoplasm was diagnosed and a suspicion of malignancy was raised. Immunohistochemistry for CD31 and CD34 was positive (Figures 1 and 2). Excision biopsy was suggested. On gross examination, the specimen consisted of a skin-covered fibrofatty piece of tissue measuring 90 · 60 · 50 mm. On sectioning there was a greyish white, well-circumscribed nodule measuring 55 · 45 · 30 mm, with a 15 · 15 mm, dark brown, ill-defined area merging with it ( Figure 3). The nodule was 15 mm away from the closest deep resection margin. Figure 1. Trucut biopsy specimen of the breast. Endothelial cells lining the vessels are immunoreactive with CD31.

High grade angiosarcoma arising in fibroadenoma

“…Only one case of angiosarcoma arising in a recurrent phyllodes tumor has been published [16]. Here we present a case of a 53 year old women with primary angiosarcoma arising in fibroadenoma.…”

Transcatheter arterial chemoembolization improves the resectability of malignant breast phyllodes tumor with angiosarcoma component: a case report

“…Such malignant phyllodes tumors account for approximately 20% of all cases. The heterologous angiosarcoma component is considerably rare, and only four cases of angiosarcoma developing in the clinical setting of a phyllodes tumor have been reported [12–15]. Our case is the fifth case in the literature.…”

Cardiopulmonary thromboembolism of epithelioid angiosarcoma arising from malignant phyllodes tumour of the breast

“…Only very rare cases of angiosarcoma developing in phyllodes tumour have been documented in literature. The two cases described by Mamoon et al 7 and Kumar et al 8 were conventional angiosarcomas that only arose within recurrences of the phyllodes tumour. In both cases, the angiosarcoma was intimately associated with the spindle cell stromal component of the phyllodes tumour.…”