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A Journal on Surgery
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Chirurgia 2014 October;27(5):293-6
Radiation associated cutaneous angiosarcoma and atypical post-radiation vascular proliferation of the breast: distinct pathological entities or not?
Accurso A. 1, Ciancia G. 2, Della Corte G. A. 1, Fulciniti F. 3, Somma A. 2, Cozzolino I. 4, Rocco N. 1
1 Department of General, Geriatric, Oncologic Surgery and Advanced Technologies, University Federico II of Naples, Naples, Italy;
2 Department of Advanced Biomedical Sciences, University Federico II of Naples, Naples, Italy;
3 Struttura Complessa di Anatomia Patologica e Citopatologia, Istituto Nazionale Tumori ‘‘Fondazione G. Pascale", Naples, Italy;
4 Department of Public Health, University Federico II of Naples, Naples, Italy
Radiation associated cutaneous angiosarcoma (RACA) of the breast represents a very rare pathological entity accounting for <0.05% of malignant breast tumors. We present a case of a 61-year-old woman diagnosed with an invasive ductal breast carcinoma submitted to a local wide excision and subsequent adjuvant radiotherapy 6 years ago. Five years after the initial diagnosis, she underwent total mastectomy for a cutaneous atypical vascular proliferation (AVP) and after ten months from the radical treatment she presented a lump at the level of the medial side of the surgical scar with a histologic diagnosis of cutaneous angiosarcoma. Following the complete surgical of the lesion, the patient performed 3D-Conformational radiotherapy directed to the thoracic wall. AVP was thought historically to be a benign, distinct entity but shares enough clinical and histologic features with angiosarcoma to raise concern that AVP and angiosarcoma may represent ends of a spectrum of radiation-associated vascular lesions. Although RACA remains an aggressive disease with a poor prognosis, we do not believe that it should dissuade breast cancer patients and oncologists from using RT as part of BCT. However, women treated with RT for breast cancer should be evaluated regularly and educated by their oncologists regarding the risks of this secondary malignancy.