Iranian Journal of Medical Sciences

Document Type : Case Report(s)

Authors

1 Breast Diseases Research Center, Department of Surgical Oncology, Shiraz University of Medical Sciences, Shiraz, Iran

2 Department of Surgery, Shahid Faghihi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran

3 Department of Pathology, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran

Abstract

Angiosarcomas are endothelial cell neoplasms in the lining of the blood vessel wall and account for about 0.04% of all breast malignancies with a high rate of error in primary diagnosis. The breast angiosarcoma is a rare and uncommon pathology and has been described mostly as case reports. Indeed, only a limited number of cases have been published. Accordingly, the natural history of this tumor and its clinical course remain unclear, and as a consequence, no uniform treatment strategy exists. We present the clinical course and challenges in the diagnosis of a primary angiosarcoma of the breast in a young woman, presenting with a mass in her left breast. Fine-needle aspiration and core needle biopsy failed to confer a correct diagnosis. She suffered severe bleeding at the time of open biopsy and underwent total mastectomy, followed by adjuvant chemotherapy. Young women with solid breast tumors, especially those that are highly vascular, should be considered malignant until proven otherwise. Accurate diagnosis may be difficult. Open biopsy can be diagnostic, although exsanguinating bleeding may occur. Thus, performing open biopsy in locations other than equipped operating rooms may be hazardous and should be avoided.

Keywords

  1. Kim YS, Kim YJ, Yim KI, Park WC. A case report of primary breast angiosarcoma with fatal pulmonary hemorrhage due to thrombocytopenia. J Korean Surg Soc. 2012;82:251-5. doi: 10.4174/jkss.2012.82.4.251. PubMed PMID: 22493767; PubMed Central PMCID: PMC3319780.
  2. Bennani A, Chbani L, Lamchahab M, Wahbi M, Alaoui FF, Badioui I, et al. Primary angiosarcoma of the breast: a case report. Diagn Pathol. 2013;8:66. doi: 10.1186/1746-1596-8-66. PubMed PMID: 23607567; PubMed Central PMCID: PMC3651285.
  3. Desbiens C, Hogue JC, Levesque Y. Primary breast angiosarcoma: avoiding a common trap. Case Rep Oncol Med. 2011;2011:517047. doi: 10.1155/2011/517047. PubMed PMID: 22611503; PubMed Central PMCID: PMC3350177.
  4. Johnson CM, Garguilo GA. Angiosarcoma of the breast: A case report and literature review. Curr Surg. 2002;59:490-4. doi: 10.1016/S0149-7944(02)00629-3. PubMed PMID: 15727796.
  5. Georgiannos SN, Sheaff M. Angiosarcoma of the breast: a 30 year perspective with an optimistic outlook. Br J Plast Surg. 2003;56:129-34. doi: 10.1016/S0007-1226(03)00025-0. PubMed PMID: 12791356.
  6. Lvoff NM, Leung JW. Case of the season: primary angiosarcoma of the breast: correlative imaging and pathology. Semin Roentgenol. 2007;42:208-10. doi: 10.1053/j.ro.2007.06.002. PubMed PMID: 17919522.
  7. Vorburger SA, Xing Y, Hunt KK, Lakin GE, Benjamin RS, Feig BW, et al. Angiosarcoma of the breast. Cancer. 2005;104:2682-8. doi: 10.1002/cncr.21531. PubMed PMID: 16288486.
  8. Zelek L, Llombart-Cussac A, Terrier P, Pivot X, Guinebretiere JM, Le Pechoux C, et al. Prognostic factors in primary breast sarcomas: a series of patients with long-term follow-up. J Clin Oncol. 2003;21:2583‑8. doi: 10.1200/JCO.2003.06.080. PubMed PMID: 12829679.
  9. Cornelis A, Verjans M, Van den Bosch T, Wouters K, Van Robaeys J, Janssens JP, et al. Efficacy and safety of direct and frontal macrobiopsies in breast cancer. Eur J Cancer Prev. 2009;18:280-4. doi: 10.1097/CEJ.0b013e328329d885. PubMed PMID: 19352188.