Abstract
ĮžangaStraipsnio tikslas – aprašyti retą klinikinį su spinduliniu gydymu susijusį angiosarkomos atvejį po krūties tausojančios operacijos ir spindulinio vėžio gydymo, taip pat apžvelgti naujausius literatūros šaltinius.Klinikinis atvejisStraipsnyje aprašomas klinikinis 66 metų moters atvejis. Jai buvo diagnozuotas kairės krūties I stadijos vėžys (pT1cN0M0).2011 metais atlikta krūtį tausojanti operacija ir taikytas pooperacinės radioterapijos kursas (50 Gy). 2016 metais, po 5 metų nuo pirminio kairės krūties vėžio sudėtinio gydymo, šioje krūtyje nustatyta su spinduliniu gydymu susijusi angiosarkoma.Mes aptariame šios retos angiosarkomos klinikinį atvejį ir galimus gydymo metodus. Ligonė buvo gydoma Nacionaliniame vėžio institute.IšvadosAnkstyva diagnostika, daugiadalykis aptarimas, agresyvus R0 chirurginis gydymas ir adjuvantinio spindulinio gydymo dozės leidžia sėkmingiau gydyti šia retą patologinę būklę. Reikalingi papildomi moksliniai tyrimai, kurie padėtų nustatyti su spinduliniu gydymu susijusios angiosarkomos gydymo indikacijas.
Highlights
Angiosarcoma after breast cancer conservative treatment is extremely rare pathology and its early diagnostic is complicated
A secondary angiosarcoma of the breast is associated with two presumed aetiologic factors: chronic lymphedema after a mastectomy with lymph node dissection (Stewart–Treves syndrome) and radiotherapy
The small difference in the risk of subsequent sarcoma for breast cancer patients receiving radiotherapy does not supersede the benefit of radiotherapy after breast preserving surgery [1, 4, 6]
Summary
Angiosarcoma (AS) of breast is a very aggressive malignant tumor of the vascular endothelium [1]. A secondary angiosarcoma of the breast is associated with two presumed aetiologic factors: chronic lymphedema after a mastectomy with lymph node dissection (Stewart–Treves syndrome) and radiotherapy. Because of RAAS rarity and difficulties in radiologic and clinical simptoms, the early diagnosis of RAAS is complicated, and the overall survival and local recurrence results are poor. This case report presents 66-years-old white postmenopausal women diagnosed and treated breast cancer pT1cN0M0 stage in National Cancer Institute, Vilnius, Lithuania. Breast ultrasonography revealed no pathological changes, axillary and regional lymph nodes were not enlarged. Final pathological examination revealed breast angiosarcoma low grade G1 (associated with local radiotherapy) R0.
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