Gurleyik Emin, Yekenkurul Erman, Gursoy Fatih, Gonullu Emin
Department of Surgery, Duzce University, Faculty of Medicine, Duzce, Turkey.
Department of Surgery, Duzce University, Faculty of Medicine, Duzce, Turkey.
Int J Surg Case Rep. 2024 Oct;123:110253. doi: 10.1016/j.ijscr.2024.110253. Epub 2024 Sep 10.
Today, breast-conserving surgery (BCS) and adjuvant radiotherapy are preferred treatments for patients with early invasive breast cancer. Radiation-induced angiosarcoma (RIAS) of the breast is a rare but serious complication of radiotherapy.
Seventy-one-year-old woman is presented to our department with a locally advanced dark red polypoid lesion on her left breast. She had left BCS, axillary dissection, and adjuvant radiotherapy for invasive breast cancer 8 years before presentation. A small tissue sample from the breast lesions was sent for histopathologic examination that the diagnosis was angiosarcoma of the breast. She had neoadjuvant chemotherapy. Following the completion of chemotherapy, a total mastectomy was performed as surgical treatment. The final histopathologic diagnosis was well-differentiated angiosarcoma.
RIAS of the breast is rare disease that develops after a several-year latency period. Locally advanced disease was initially treated with neoadjuvant chemotherapy which appears to be effective for significant disease regression. Patients who respond well to chemotherapy in vivo may have higher disease-specific survival rates. After chemotherapy-induced regression of locally advanced sarcoma, total mastectomy was performed for radical treatment.
RIAS of the breast is defined as the histological diagnosis of angiosarcoma in an irradiated region after a long latency period in a patient who has previously received radiotherapy for breast carcinoma. Based on clinical and nuclear imaging data, we may conclude that neoadjuvant chemotherapy can result in significant disease regression, and following neoadjuvant chemotherapy the treatment of angiosarcoma is completed by radical breast surgery.
如今，保乳手术（BCS）和辅助放疗是早期浸润性乳腺癌患者的首选治疗方法。乳腺放射性诱导血管肉瘤（RIAS）是放疗的一种罕见但严重的并发症。
一名71岁女性因左乳出现局部晚期暗红色息肉样病变前来我院就诊。她在就诊前8年因浸润性乳腺癌接受了左乳保乳手术、腋窝清扫和辅助放疗。从乳腺病变处取了一小块组织样本送去做组织病理学检查，诊断为乳腺血管肉瘤。她接受了新辅助化疗。化疗结束后，进行了全乳切除术作为手术治疗。最终组织病理学诊断为高分化血管肉瘤。
乳腺RIAS是一种罕见疾病，在数年的潜伏期后发生。局部晚期疾病最初采用新辅助化疗进行治疗，这似乎对显著的疾病消退有效。在体内对化疗反应良好的患者可能有更高的疾病特异性生存率。在化疗导致局部晚期肉瘤消退后，进行全乳切除术以进行根治性治疗。
乳腺RIAS被定义为在先前接受过乳腺癌放疗的患者中，经过长时间潜伏期后，在放疗区域内血管肉瘤的组织学诊断。根据临床和核成像数据，我们可以得出结论，新辅助化疗可导致显著的疾病消退，新辅助化疗后，通过根治性乳腺手术完成血管肉瘤的治疗。
