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一例原发性乳腺血管肉瘤伴血小板减少致致命性肺出血的病例报告。

A case report of primary breast angiosarcoma with fatal pulmonary hemorrhage due to thrombocytopenia.

作者信息

Kim Yong-Seok, Kim Young-Joong, Yim Kwang-Il, Park Woo-Chan

机构信息

Department of Surgery, The Catholic University of Korea School of Medicine, Seoul, Korea.

出版信息

J Korean Surg Soc. 2012 Apr;82(4):251-5. doi: 10.4174/jkss.2012.82.4.251. Epub 2012 Mar 27.

Abstract

Primary angiosarcomas of the breast are rare malignancy that account for fewer than 0.04% of all malignant breast tumors. The prognosis is poor. Surgery is the first line of treatment for angiosarcoma. Adjuvant chemotherapy and radiotherapy have been tried, but their efficacy remains controversial. Here we present the case of a 47-year-old woman with a palpable left breast mass that was diagnosed as a primary angiosarcoma. The patient underwent modified radical mastectomy with adjuvant chemotherapy and radiotherapy. Postoperatively, eighteen months later, the angiosarcoma recurred. The patient returned complaining of dyspnea and hemoptysis and was found to have a large pleural effusion. She developed a gradual onset of thrombocytopenia that persisted despite platelet transfusions. Finally, the patient died of respiratory failure secondary to pulmonary hemorrhage.

摘要

乳腺原发性血管肉瘤是一种罕见的恶性肿瘤,占所有乳腺恶性肿瘤的比例不到0.04%。其预后较差。手术是血管肉瘤的一线治疗方法。辅助化疗和放疗也已尝试过,但其疗效仍存在争议。在此,我们报告一例47岁女性病例,其左乳可触及肿块,诊断为原发性血管肉瘤。该患者接受了改良根治性乳房切除术,并辅以化疗和放疗。术后18个月,血管肉瘤复发。患者因呼吸困难和咯血复诊,发现有大量胸腔积液。她逐渐出现血小板减少,尽管输注了血小板仍持续存在。最终,患者死于肺出血继发的呼吸衰竭。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4848/3319780/c92b1962d75c/jkss-82-251-g001.jpg

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