Recurrent Primary Angiosarcoma of Breast–A Rare Entity

Abstract

Angiosarcoma of the breast is a rare tumour with a reported incidence of only 0.04% of all breast malignancies. A 34-year-old lady presented with a lump in her right breast. In view of haemorrhage and few stromal fragments on Fine Needle Aspiration Cytology (FNAC), a diagnosis of phylloides was given. Simple mastectomy was done which showed a tumour with areas of haemorrhage. On microscopy anastomosing irregular vascular channels filled with RBC’s were noted. Sheets of tumour cells with high mitotic activity was observed at places. There were areas of haemorrhage and ischaemic necrosis. A diagnosis of angiosarcoma was made which was confirmed by immunohistochemistry (CD 34 and factor VIII). Eight months later she presented with a recurrent lump in her right chest wall following which lumpectomy was done. Microscopy showed similar features as in the earlier mastectomy specimen. On reviewing the fine needle aspiration slides we realised that the endothelial fragments were mistaken for stromal fragments.The importance of this case report lies in the fact that primary breast angiosarcoma is a rare tumour which can develop without radiation exposure/history of previous breast surgery. The presence of spindle cells on fine needle aspiration slides necessitates careful examination and evaluation to rule out malignancy. It is important that the cytopathologist is aware of this possibility, to enable an early diagnosis