Boyan William, Farr M, Georges Renee
Monmouth Medical Center, Monmouth Medical Center, 300 Second Ave, Long Branch, NJ 07740, United States.
St. Georges University, Monmouth Medical Center, 300 Second Ave, Long Branch, NJ 07740, United States.
Int J Surg Case Rep. 2014;5(12):1176-7. doi: 10.1016/j.ijscr.2014.11.042. Epub 2014 Nov 18.
Angiosarcoma is a rare tumor of the breast. Secondary angiosarcoma of the breast refers specifically to a tumor that arises after a latency period following radiation. With breast conservation therapy gaining significant popularity to that of mastectomy, more cases of secondary angiosarcoma continue to arise in the irradiated fields of these patients.
The authors describe the case of an 80 year old female who presented fifteen years after her surgery and radiation treatment with two bleeding skin lesions in her breast. These lesions were found to be high grade angiosarcoma upon excision. Due to high cardiac co-morbidity she was treated with re-excision and surveillance.
This case is an example of a rare sequela to a common procedure. Breast conservation therapy with lumpectomy and radiation has become a popular technique in treating localized breast cancer. Radiation like all therapy has its known adverse effects. Further work is needed with the small amount of published cases of angiosarcoma after breast irradiation so that we may find optimal treatment plans for these patients. Like any rare entity, difficulty lies in accruing enough cases to compare prognosis and results.
Secondary breast angiosarcoma diagnosis requires frequent follow ups and a high index of suspicion. With mastectomy giving the best chance of treatment in these cases, early detection is crucial in this rare sequela.
血管肉瘤是一种罕见的乳腺肿瘤。乳腺继发性血管肉瘤具体是指在放疗后的潜伏期后出现的肿瘤。随着保乳治疗相对于乳房切除术越来越受欢迎,这些患者的放疗区域出现了更多继发性血管肉瘤病例。
作者描述了一名80岁女性的病例,她在手术和放疗15年后,乳房出现了两处出血性皮肤病变。切除后发现这些病变为高级别血管肉瘤。由于心脏合并症严重,她接受了再次切除和监测治疗。
该病例是常见手术罕见后遗症的一个例子。保乳手术加肿块切除术和放疗已成为治疗局限性乳腺癌的常用技术。像所有治疗方法一样,放疗有其已知的不良反应。对于已发表的少量乳腺放疗后血管肉瘤病例,还需要进一步研究,以便我们能为这些患者找到最佳治疗方案。像任何罕见疾病一样,难点在于积累足够多的病例来比较预后和结果。
乳腺继发性血管肉瘤的诊断需要频繁随访和高度怀疑指数。在这些病例中,乳房切除术提供了最佳治疗机会,早期发现对于这种罕见后遗症至关重要。