Rare case of littoral cell angioma recognised on CT simulation for adjuvant radiation treatment for early stage breast cancer

Abstract

A 63-year-old woman with pathological anatomic/prognostic stage IA ER+/PR+/HER2- multifocal invasive mammary carcinoma with mixed ductal and lobular features of the left breast underwent lumpectomy with sentinel lymph node biopsy. During evaluation of the CT simulation for adjuvant radiation (RT) treatment planning, a liver lesion and splenomegaly were noted. A subsequent MRI abdomen revealed a large, indeterminate splenic lesion with a wide differential and a benign liver cyst. The patient ultimately underwent splenectomy, with pathology consistent with littoral cell angioma, a rare entity associated with several malignancies. At last follow-up, 7 months after completion of RT, she remained cancer free while on anastrazole and was doing well clinically.

Littoral cell angiomas: Benign lesion with a penchant for visceral malignancies

“…LCA is frequently associated with a wide range of malignancies, including epithelial, mesenchymal, and hematological tumors. To date, there have been at least 24 reports of LCA associated with a malignancy (8 patients had a pre-existing malignancy years before; 13 at the time of diagnosis of LCA) (Table 2) [3,5,7,8,13,17,23,[26][27][28][29][30][31][32][33][34][35][36][37][38][39][40]. The wide range of tumors associated with LCA makes it difficult to draw any conclusions regarding its possible pathogenesis.…”