Shet Tanuja, Malaviya Alopa, Nadkarni Mandar, Kakade Anagha, Parmar Vani, Badwe Rajan, Chinoy Roshni
Department of Pathology, Tata Memorial Hospital, Parel, Mumbai, India.
J Surg Oncol. 2006 Oct 1;94(5):368-74. doi: 10.1002/jso.20593.
Primary angiosarcomas of breast are rare tumors, with a fatal outcome.
We studied histological prognostic factors and c-kit expression by immunohistochemistry (IHC) in 12 angiosarcomas accessioned at a cancer referral center in India.
All patients had primary angiosarcoma; no case of secondary angiosarcoma was accessioned during the study period. Median age of patients was 24.5 years. Nine patients had intermediate grade tumors, one a well differentiated tumor and three patients had high-grade tumors. Interesting cases encountered included an epithelioid angiosarcoma and an angiosarcoma arising on the background of a biphasic tumor. Eight patients had lumpectomy, four mastectomy and two patients were given radiotherapy. Of the nine patients (seven type I/II and two high grade) with follow up, eight patients developed disseminated metastases within a year of presentation. The patient with well-differentiated angiosarcoma also died of metastasis albeit after a longer time. On IHC c-kit staining was weakly seen in two cases.
Primary angiosarcoma was fatal in young Indian women even in lower grade tumors. The low expression of c-kit on IHC suggests that targeting this protein for therapy may not be successful in treating these tumors.
乳腺原发性血管肉瘤是罕见肿瘤,预后不良。
我们通过免疫组织化学(IHC)研究了印度一家癌症转诊中心收录的12例血管肉瘤的组织学预后因素和c-kit表达情况。
所有患者均为原发性血管肉瘤;研究期间未收录到继发性血管肉瘤病例。患者的中位年龄为24.5岁。9例患者为中级肿瘤,1例为高分化肿瘤,3例为高级肿瘤。遇到的有趣病例包括1例上皮样血管肉瘤和1例在双相肿瘤背景下发生的血管肉瘤。8例患者接受了肿块切除术,4例接受了乳房切除术,2例患者接受了放疗。在9例接受随访的患者中(7例I/II型和2例高级别),8例患者在就诊后一年内出现了广泛转移。高分化血管肉瘤患者也死于转移,尽管时间较长。免疫组织化学检测中,2例患者的c-kit染色呈弱阳性。
原发性血管肉瘤对年轻印度女性来说是致命的,即使是低级别肿瘤。免疫组织化学检测中c-kit的低表达表明,针对该蛋白进行治疗可能无法成功治疗这些肿瘤。