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放射性相关乳腺血管肉瘤

Radiation-Associated Breast Angiosarcoma.

作者信息

Yoshino Ryusei, Yoshida Nana, Ujiie Nanami, Ito Akane, Nakatsubo Masaki, Kamikokura Yuki, Kitada Masahiro

机构信息

Thoracic Surgery and Breast Surgery, Asahikawa Medical University Hospital, Asahikawa, JPN.

Diagnostic Pathology, Asahikawa Medical University Hospital, Asahikawa, JPN.

出版信息

Cureus. 2023 Oct 8;15(10):e46673. doi: 10.7759/cureus.46673. eCollection 2023 Oct.

Abstract

Radiation-associated breast angiosarcomas are rare following breast-conserving surgery. These angiosarcomas are considered adverse events associated with radiation therapy and are characterized by a high risk of both local and distant recurrence, even after complete resection. Despite this, there is currently no established standard treatment for them. The patient was a 70-year-old woman who had breast-conserving surgery for right breast cancer 10 years before presentation. She was followed up for 10 years after receiving 50 Gy of residual breast irradiation and an aromatase inhibitor for 5 years. During follow-up, a painless purplish area with induration, measuring 10 cm by 5.4 cm, was noted on the right nipple. A skin biopsy confirmed hemangiosarcoma. Treatment included surgery with a 2.0 cm margin from the area, followed by skin excision and total mastectomy. A final diagnosis of radiation-associated breast angiosarcoma was made. Radiation-associated breast angiosarcoma is a rare disease with a poor prognosis that lacks standard treatment. An aggressive skin biopsy should be considered when skin findings such as purpura are seen after breast cancer radiotherapy, as in this case.

摘要

保乳手术后发生的放射性乳腺血管肉瘤较为罕见。这些血管肉瘤被视为与放射治疗相关的不良事件,其特征是即使在完全切除后,局部和远处复发风险仍很高。尽管如此,目前尚无针对它们的既定标准治疗方法。该患者为一名70岁女性,就诊前10年因右乳腺癌接受了保乳手术。在接受50 Gy的残留乳腺照射及5年芳香化酶抑制剂治疗后,她接受了10年的随访。随访期间,在右乳头发现一个无痛性紫色硬结区,大小为10 cm×5.4 cm。皮肤活检确诊为血管肉瘤。治疗包括距该区域边缘2.0 cm进行手术,随后进行皮肤切除和全乳切除术。最终诊断为放射性乳腺血管肉瘤。放射性乳腺血管肉瘤是一种预后不良的罕见疾病,缺乏标准治疗方法。如本病例所示,乳腺癌放疗后出现紫癜等皮肤表现时,应考虑进行积极的皮肤活检。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c960/10628990/1e74852e23fa/cureus-0015-00000046673-i01.jpg

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