Losch Andrea, Chilek Katherine D, Zirwas Matthew J
J Clin Aesthet Dermatol. 2011 Apr;4(4):47-8.
Angiosarcoma is an aggressive tumor that most commonly presents on the scalp or face of elderly patients; however, it can develop in pateints with breast cancer following radiation and breast-conserving therapy, complicating 0.1 to 0.2 percent of such cases. Mammography and fine-needle aspiration, though often very useful in evaluating for breast carcinomas and cytological features, are often negative in early stages of angiosarcoma and difficult to interpret. We present the case of a 49-year-old Caucasian woman with a history of stage II invasive ductal carcinoma of the left breast who presented with a two-month history of increased firmness and tenderness in her left breast. On exam, her left breast had significant firmness and hardening of breast tissue with slight erythema of skin. Punch biopsy initially suggested angiosarcoma, but subsequent biopsies instead diagnosed an atypical vascular proliferation. This case represents a patient who presented with an atypical lesion concerning for angiosarcoma. Repeated biopsies were necessary to obtain the correct diagnosis. One biopsy may not be sufficient for distinguishing atypical vascular proliferation from angiosarcoma. We present this case to increase awareness of the difficulty in making this distinction.
血管肉瘤是一种侵袭性肿瘤，最常见于老年患者的头皮或面部；然而，它也可能在接受放疗和保乳治疗的乳腺癌患者中发生，在这类病例中占比0.1%至0.2%，使病情复杂化。乳房X线摄影和细针穿刺抽吸检查，尽管在评估乳腺癌和细胞学特征方面通常非常有用，但在血管肉瘤早期往往呈阴性，且难以解读。我们报告一例49岁的白人女性病例，她有左乳II期浸润性导管癌病史，出现左乳硬度增加和压痛两个月。检查时，她的左乳乳房组织明显变硬，皮肤略有红斑。打孔活检最初提示为血管肉瘤，但随后的活检诊断为非典型血管增生。该病例代表了一名出现疑似血管肉瘤的非典型病变的患者。为获得正确诊断，重复活检是必要的。一次活检可能不足以区分非典型血管增生和血管肉瘤。我们展示此病例以提高对做出这种区分困难的认识。
