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Giornale Italiano di Dermatologia e Venereologia 2002 December;137(6):415-20

Copyright © 2002 EDIZIONI MINERVA MEDICA

language: Italian

Cutaneous angiosarcoma of the breast after radiation therapy. Description of a case and survey of the literature

Tomasini C., Grassi M., Pippione M.

Clinica Dermatologica II, Università degli Studi di Torino, Torino


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Angiosarcoma is a malignant tumor with endothelial differentiation manifesting in 3 highly characteristic clinical settings: cutaneous angiosarcoma of the head and scalp in, the elderly, cutaneous angiosarcoma associated with lymphedema, and radiation-induced angiosarcoma. The Authors describe a case of cutaneous mammary angiosarcoma developed in a 70-year-old woman who had breast-sparing surgery and radiation for breast carcinoma coupled with axillary lymph node dissection. The cutaneous lesions developed 3 years after radiation and there was no lymphedema of the residual breast. The patient has been treated with systemic chemotherapy and she is alive without metastases of angiosarcoma at 3 year follow-up. Radiation-induced angiosarcoma of the breast is extremely uncommon. In the literature, including the present case, 23 cases have been described. The review of this series shows that radiation-induced mammary angiosarcoma affects more often women over sixty who have had breast-sparing surgery and radiation coupled with axillary lymph node dissection. Most of these patients have not had lymphedema, suggesting that the significant common thema is radiation. However, because latencies in the group of patients with mammary angiosarcoma are relatively shorter compared with other postirradiation angiosarcoma, minor role of subclinical lymphedema cannot be excluded. This variety of angiosarcoma shows similar clinical, histological, and biological features to other angiosarcomas. Differential diagnosis includes mainly cutaneous metastases of breast carcinoma, Kaposi’s sarcoma, and atypical vascular proliferation induced by radiation.

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