Moskaluk C A, Merino M J, Danforth D N, Medeiros L J
Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892.
Hum Pathol. 1992 Jun;23(6):710-4. doi: 10.1016/0046-8177(92)90331-v.
A case of low-grade angiosarcoma arising in the skin of a breast previously irradiated for breast carcinoma is reported. Initially, an asymptomatic breast mass was detected. Excisional biopsy and axillary lymph node dissection revealed a 1.5-cm infiltrating ductal carcinoma with 21 negative lymph nodes. The neoplasm was staged as T1, N0, M0. The patient was entered in a research protocol and was treated with high-dose external beam (4,860 rad) and iridium implant (1,860 rad) irradiation. Seven years later the patient developed low-grade angiosarcoma of the breast skin. The lesion recurred following excision and eventually was treated by simple mastectomy. The patient never had evidence of lymphedema. Cutaneous angiosarcomas occurring as a complication of lumpectomy and radiation therapy for breast carcinoma are rare. In some reported cases the patients have had lymphedema, a known factor predisposing to angiosarcoma. Furthermore, almost all cases previously reported have been high grade. This case suggests that radiation therapy for breast carcinoma may also be complicated by low-grade angiosarcoma.
报告了1例发生于既往因乳腺癌接受过放疗的乳腺皮肤的低级别血管肉瘤。最初，发现一个无症状的乳腺肿块。切除活检及腋窝淋巴结清扫显示为1.5 cm浸润性导管癌，21枚淋巴结阴性。肿瘤分期为T1、N0、M0。该患者进入一项研究方案，接受了高剂量外照射（4860拉德）及铱植入（1860拉德）放疗。7年后，患者发生了乳腺皮肤低级别血管肉瘤。病变切除后复发，最终行单纯乳房切除术治疗。该患者从未有过淋巴水肿的证据。作为乳腺癌保乳手术及放疗并发症出现的皮肤血管肉瘤很罕见。在一些报道的病例中，患者有淋巴水肿，这是已知的血管肉瘤易感因素。此外，几乎所有既往报道的病例均为高级别。该病例提示，乳腺癌放疗也可能并发低级别血管肉瘤。
