Horisawa Nanae, Adachi Yayoi, Sawaki Masataka, Hattori Masaya, Yoshimura Akiyo, Gondo Naomi, Kotani Haruru, Kataoka Ayumi, Sugino Kayoko, Mori Makiko, Terada Mitsuo, Ozaki Yuri, Iwata Hiroji
Department of Breast Oncology, Aichi Cancer Center Hospital, 1-1 Kanokoden, chikusa-ku, Nagoya, Aichi, 〒464-8681, Japan.
Surg Case Rep. 2018 Nov 7;4(1):131. doi: 10.1186/s40792-018-0538-9.
Radiation-associated angiosarcoma (RAAS) is a rare subtype of secondary angiosarcoma that is characterized by rapid proliferation and extensive tissue infiltration. Although various treatments for RAAS (such as surgery, chemotherapy, and radiation therapy) have been reported, there is no consensus as to which approach is the best.
A 76-year-old woman presented with right breast cancer (T1N0M0, stage I) 9 years ago. She had undergone breast-conserving surgery and sentinel lymph node biopsy and was receiving adjuvant chemotherapy and radiation therapy for the malignancy. Six years after presenting with the tumor, she developed pigmented skin and was diagnosed with a RAAS; this angiosarcoma recurred three times within 2 years. The angiosarcoma was resected each of the three times, after which adjuvant radiation therapy was performed. At 76 years old, the patient developed a new mass on her chest skin in the vicinity of the scar. Angiosarcoma was diagnosed following a pathology report, which resulted in a second diagnosis of recurrent RAAS again since the diagnostic criteria were met. After extensive resection of the irradiated area, the patient has remained free of angiosarcoma for the last 3 years.
Resection of the entire irradiated field is critical for successful treatment of RAAS.
放射性血管肉瘤(RAAS)是继发性血管肉瘤的一种罕见亚型,其特征为快速增殖和广泛的组织浸润。尽管已有关于RAAS的各种治疗方法(如手术、化疗和放疗)的报道,但对于哪种方法最佳尚无共识。
一名76岁女性9年前被诊断为右乳腺癌(T1N0M0,I期)。她接受了保乳手术和前哨淋巴结活检,并正在接受针对该恶性肿瘤的辅助化疗和放疗。出现肿瘤6年后,她出现了皮肤色素沉着,被诊断为RAAS;这种血管肉瘤在2年内复发了3次。每次血管肉瘤复发均进行了切除,之后进行了辅助放疗。76岁时,患者在瘢痕附近的胸部皮肤出现了一个新肿块。病理报告后诊断为血管肉瘤,由于符合诊断标准,再次诊断为复发性RAAS。在对受照射区域进行广泛切除后,患者在过去3年中一直未再出现血管肉瘤。
切除整个受照射区域对于成功治疗RAAS至关重要。