Primary breast angiosarcoma: a case report

Abstract

Background Angiosarcomas are rare and fast growing tumors that arise from vascular structures. This case report is significant because it is rare and may cause treatment delay if not considered as a differential diagnosis. Hence, we aim to inform efficient, appropriate, and evidence-based imaging practice to the benefit of patients regionally and worldwide. Case presentation Thirty-five-year-old lady, presented with a large left breast swelling. She had recent history of trauma to the breast which initially caused confusion regarding the possible diagnosis. Ultrasound and MRI raised high suspicion of an angiosarcoma. Patient went through embolectomy prior to mastectomy and axillary clearance. Histopathology confirmed the diagnosis of an angiosarcoma. She had no distant metastases at the time of diagnosis and the patient was treated with chemotherapy and radiotherapy. However, she returned with recurrence within 1-year duration. Conclusion Primary breast angiosarcomas are rare aggressive vascular tumors with generally poor prognosis and no pathognomonic signs on radiological imaging, especially mammogram. Ultrasound and MRI do help in characterizing these tumors and raising the suspicion of a vascular tumor. Ultrasound-guided biopsy is recommended to avoid unnecessary complications. In young patients with rapidly growing, highly vascular breast tumors, a differential diagnosis of primary angiosarcomas should be considered until proven otherwise.

Bilateral primary angiosarcoma of the breast: a case report

“…It is a highly malignant tumor with a poor prognosis [ 2 , 7 ], and the median survival is usually 24 months with a 5-year recurrence-free survival rate of only 33% [ 4 ]. Tumor histology, grade, size, and invasion into surgical margins have been reported as prognostic factors [ 8 ]. Zelek [ 9 ] et al .…”

“…Diagnosis of angiosarcoma can be difficult because most imaging findings are nonspecific [ 8 ]. On mammography, findings are highly nonspecific, with 33% of mammary angiosarcomas presenting with normal mammograms, as reported by Liberman [ 10 ]; MRI is reported to show a low T1 signal and markedly high T2 signal, and the dynamic phase shows early staining followed by persistent staining [ 8 ]. Fine-needle aspiration cytology and core biopsy show false-negative results as high as 37% [ 6 ].…”

Primary angiosarcoma of breast in an octogenarian woman: A case report with literature review

“…Breast angiosarcomas may have an initially clinical silent course presenting usually as a painless palpable mass that may enlarge rapidly. Other clinical manifestations varies from purplish or eczematous rash, hematoma formation to diffuse breast enlargement [5] , [6] . Male breasts are not exempted from these type of tumours and up to sixth cases have been present in the published data [7] .…”