10. Primary angiosarcoma of the breast in a 29-year old female

Abstract

Background: Primary angiosarcoma of the breast is a relatively rare entity with less than 0.05% of all malignant breast tumours. Aims: Provide in-depth study of a 29-year-old female with primary angiosarcoma of the breast and review related literature. Methods: Review all the data which include patient’s demographic, history, radiographic findings, management, histopathology findings, and outcome. Results and conclusions: Case of a 29-year-old Filipino female with nine months history of right breast mass. Work-up favoured breast haemangioma versus phyllodes tumour. Patient underwent right modified radical mastectomy with axillary lymph node dissection. The specimen revealed a unilocular space measuring 17×12×12 cm and partly-filled with a mixture of clotted blood and spongy to soft black materials which were adherent to the cavity wall. Microsections showed an infiltrating neoplasm of anastomosing blood-filled vascular channels with prominent papillary growth of neoplastic endothelial cells extending 0.5 cm away from the basal margin. The neoplastic endothelial cells were pleomorphic with large, round to ovoid, and vesicular nuclei, prominent nucleoli, and eosinophilic cytoplasm. Mitosis was frequent (>19/10 HPF). Necrosis was nil. All nine lymph nodes were negative for involvement. The neoplastic cells showed strong reactivity against CD34 and focal reactivity against Factor VIII. Surgical pathology diagnosis was a conventional angiosarcoma, FNCLCC grade 2. Cycles of chemotherapy (paclitaxel, doxorubicin, and ifosfamide) were also started. Seven months post-operation CT-scan reveal liver masses. The disease progressed and she eventually died a year after. Studies to verify the correlation between histopathologic grade, clinical and radiologic data, and patient outcomes are needed to develop the most reliable treatment options. Reference1.Bordoni D, Bolletta E, Falco G, et al. Primary angiosarcoma of the breast. Int J Surg Case Rep 2016; 20S (Suppl): 12–5.