A case of primary breast angiosarcoma with multiple discontinuous small lesions
Abstract Background Angiosarcoma of the breast is rare. It carries a poor prognosis because of its high risk of local recurrence and distant metastases. Presently, there are still no established systemic therapies. Thus, the main treatment strategy for breast angiosarcoma is complete resection. This...
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doaj-b5e3720ea8044b8a88bb36e7413790172020-11-25T03:09:36ZengSpringerOpenSurgical Case Reports2198-77932019-10-01511510.1186/s40792-019-0704-8A case of primary breast angiosarcoma with multiple discontinuous small lesionsAsako Sasahara0Masahiko Tanabe1Kanako Hayashi2Takaaki Konishi3Mariko Oya4Kana Sakiyama5Arisa Morizono6Mayumi Harada7Kazutaka Otsuji8Yuko Ishibashi9Ayaka Sato10Yasuko Kikuchi11Takayoshi Niwa12Munetoshi Hinata13Kotoe Nishioka14Yasuyuki Seto15Department of Breast and Endocrine Surgery, Graduate School of Medicine, The University of TokyoDepartment of Breast and Endocrine Surgery, Graduate School of Medicine, The University of TokyoDepartment of Breast and Endocrine Surgery, Graduate School of Medicine, The University of TokyoDepartment of Breast and Endocrine Surgery, Graduate School of Medicine, The University of TokyoDepartment of Breast and Endocrine Surgery, Graduate School of Medicine, The University of TokyoDepartment of Breast and Endocrine Surgery, Graduate School of Medicine, The University of TokyoDepartment of Breast and Endocrine Surgery, Graduate School of Medicine, The University of TokyoDepartment of Breast and Endocrine Surgery, Graduate School of Medicine, The University of TokyoDepartment of Breast and Endocrine Surgery, Graduate School of Medicine, The University of TokyoDepartment of Breast and Endocrine Surgery, Graduate School of Medicine, The University of TokyoDepartment of Breast and Endocrine Surgery, Graduate School of Medicine, The University of TokyoDepartment of Breast and Endocrine Surgery, Graduate School of Medicine, The University of TokyoDepartment of Breast and Endocrine Surgery, Graduate School of Medicine, The University of TokyoDepartment of Pathology, The University of Tokyo HospitalDepartment of Breast and Endocrine Surgery, Graduate School of Medicine, The University of TokyoDepartment of Breast and Endocrine Surgery, Graduate School of Medicine, The University of TokyoAbstract Background Angiosarcoma of the breast is rare. It carries a poor prognosis because of its high risk of local recurrence and distant metastases. Presently, there are still no established systemic therapies. Thus, the main treatment strategy for breast angiosarcoma is complete resection. This underscores the importance of closely monitoring the spread of the tumor lesion, particularly for multifocal angiosarcoma, and to plan an optimal operative procedure. We herein present the successful surgical treatment of a rare case of multifocal primary breast angiosarcoma. Case presentation A 43-year-old woman visited our hospital with a growing lump on her right breast accompanied by pain. Clinical and radiological examinations revealed a well-circumscribed 40-mm-diameter tumor at the inner lower quadrant of her right breast. Histological examination of a needle biopsy specimen revealed angiosarcoma. Based on a precise evaluation of the tumor by contrast-enhanced MRI and contrast-enhanced CT scan, a wide local excision with sufficient margins was performed. In the resected specimen, three discontinuous small lesions of angiosarcoma were observed around the main tumor. Therefore, total mastectomy was additionally performed. Pathological examination revealed two other small nodules of angiosarcoma in the remnant right breast, which appeared to be close but not continuous to the defective part of the initial resection. Postoperative follow-up at 1 year showed no signs of recurrence or distant metastasis. Multifocal primary breast angiosarcoma is extremely rare with only two previous reports describing its multifocality. Conclusions Owing to its rarity, a standardized surgical treatment for breast angiosarcoma remains controversial. Our case suggests that primary breast angiosarcoma may occasionally present with multifocal tumor. Thus, it is important to keep in mind the multifocality of breast angiosarcoma when assessing its spread by diagnostic imaging and when planning the surgical strategy.http://link.springer.com/article/10.1186/s40792-019-0704-8AngiosarcomaBreastMultifocal tumorSurgery |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Asako Sasahara Masahiko Tanabe Kanako Hayashi Takaaki Konishi Mariko Oya Kana Sakiyama Arisa Morizono Mayumi Harada Kazutaka Otsuji Yuko Ishibashi Ayaka Sato Yasuko Kikuchi Takayoshi Niwa Munetoshi Hinata Kotoe Nishioka Yasuyuki Seto |
spellingShingle |
Asako Sasahara Masahiko Tanabe Kanako Hayashi Takaaki Konishi Mariko Oya Kana Sakiyama Arisa Morizono Mayumi Harada Kazutaka Otsuji Yuko Ishibashi Ayaka Sato Yasuko Kikuchi Takayoshi Niwa Munetoshi Hinata Kotoe Nishioka Yasuyuki Seto A case of primary breast angiosarcoma with multiple discontinuous small lesions Surgical Case Reports Angiosarcoma Breast Multifocal tumor Surgery |
author_facet |
Asako Sasahara Masahiko Tanabe Kanako Hayashi Takaaki Konishi Mariko Oya Kana Sakiyama Arisa Morizono Mayumi Harada Kazutaka Otsuji Yuko Ishibashi Ayaka Sato Yasuko Kikuchi Takayoshi Niwa Munetoshi Hinata Kotoe Nishioka Yasuyuki Seto |
author_sort |
Asako Sasahara |
title |
A case of primary breast angiosarcoma with multiple discontinuous small lesions |
title_short |
A case of primary breast angiosarcoma with multiple discontinuous small lesions |
title_full |
A case of primary breast angiosarcoma with multiple discontinuous small lesions |
title_fullStr |
A case of primary breast angiosarcoma with multiple discontinuous small lesions |
title_full_unstemmed |
A case of primary breast angiosarcoma with multiple discontinuous small lesions |
title_sort |
case of primary breast angiosarcoma with multiple discontinuous small lesions |
publisher |
SpringerOpen |
series |
Surgical Case Reports |
issn |
2198-7793 |
publishDate |
2019-10-01 |
description |
Abstract Background Angiosarcoma of the breast is rare. It carries a poor prognosis because of its high risk of local recurrence and distant metastases. Presently, there are still no established systemic therapies. Thus, the main treatment strategy for breast angiosarcoma is complete resection. This underscores the importance of closely monitoring the spread of the tumor lesion, particularly for multifocal angiosarcoma, and to plan an optimal operative procedure. We herein present the successful surgical treatment of a rare case of multifocal primary breast angiosarcoma. Case presentation A 43-year-old woman visited our hospital with a growing lump on her right breast accompanied by pain. Clinical and radiological examinations revealed a well-circumscribed 40-mm-diameter tumor at the inner lower quadrant of her right breast. Histological examination of a needle biopsy specimen revealed angiosarcoma. Based on a precise evaluation of the tumor by contrast-enhanced MRI and contrast-enhanced CT scan, a wide local excision with sufficient margins was performed. In the resected specimen, three discontinuous small lesions of angiosarcoma were observed around the main tumor. Therefore, total mastectomy was additionally performed. Pathological examination revealed two other small nodules of angiosarcoma in the remnant right breast, which appeared to be close but not continuous to the defective part of the initial resection. Postoperative follow-up at 1 year showed no signs of recurrence or distant metastasis. Multifocal primary breast angiosarcoma is extremely rare with only two previous reports describing its multifocality. Conclusions Owing to its rarity, a standardized surgical treatment for breast angiosarcoma remains controversial. Our case suggests that primary breast angiosarcoma may occasionally present with multifocal tumor. Thus, it is important to keep in mind the multifocality of breast angiosarcoma when assessing its spread by diagnostic imaging and when planning the surgical strategy. |
topic |
Angiosarcoma Breast Multifocal tumor Surgery |
url |
http://link.springer.com/article/10.1186/s40792-019-0704-8 |
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