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放疗后早期乳腺血管肉瘤的发生:一则警示故事

Early Breast Angiosarcoma Development After Radiotherapy: A Cautionary Tale.

作者信息

Wei Nicholas J J, Crowley Timothy P, Ragbir Maniram

机构信息

From the Department of Plastic Surgery, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom.

出版信息

Ann Plast Surg. 2019 Aug;83(2):152-153. doi: 10.1097/SAP.0000000000001856.

Abstract

This is a short clinical report depicting an exceptionally early presentation of radiation-induced angiosarcoma and overview of the literature. This case highlights the need for a high level of clinical suspicion in those patients presenting with unresolving cutaneous skin changes after radiotherapy for breast cancer.Breast-conserving therapy, comprising breast-conserving surgery and adjuvant radiotherapy, has largely replaced mastectomy in the treatment of early-stage breast carcinoma. Breast angiosarcoma is a rare but severe long-term complication associated with postoperative radiotherapy (Int J Radiat Oncol Biol Phys. 2002;52:1231-1237). It often presents as a bluish/purple skin lesion in a breast previously treated for breast cancer. This case explores an unexpectedly early presentation of radiation-induced breast angiosarcoma, which was initially thought to be benign bruising. Management remains challenging and prognosis is poor because of its aggressive local and regional invasion and early metastasis, commonly to the lungs and liver. Early surgical resection with wide margins is the treatment of choice (J Plast Reconstr Aesthet Surg. 2011;64:1036-1042).

摘要

这是一份简短的临床报告,描述了放射性血管肉瘤异常早期的表现及文献综述。该病例强调,对于那些在乳腺癌放疗后出现持续性皮肤改变的患者,需要高度的临床怀疑。保乳治疗,包括保乳手术和辅助放疗,在早期乳腺癌的治疗中已在很大程度上取代了乳房切除术。乳腺血管肉瘤是一种与术后放疗相关的罕见但严重的长期并发症(《国际放射肿瘤学、生物学、物理学杂志》。2002年;52:1231 - 1237)。它常表现为先前接受过乳腺癌治疗的乳房出现蓝紫色皮肤病变。本病例探讨了放射性诱导的乳腺血管肉瘤意外早期的表现,最初被认为是良性瘀伤。由于其侵袭性的局部和区域侵犯以及早期转移,通常转移至肺和肝,治疗仍然具有挑战性且预后较差。首选的治疗方法是进行切缘广泛的早期手术切除(《整形与重建美容外科杂志》。2011年;64:1036 - 1042)。

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