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Angiosarcoma of the breast
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Presentation A 57-year-old woman presented with a recently palpable mass in the left breast. Prior yearly screening mammograms have been negative. Patient has a history of Hodgkins disease treated successfully 25 yrs ago and has been disease free since then.
Caption: Comparative cranio-caudal views of the breast
Description: An area of increased density with highly irregular margins is seen in the left breast [clinically corresponds to the palpable abnormality]. Few foci of benign calcification are seen in the right breast.
Caption: Comparative medio-lateral oblique views
Description: The area of increased density is localized to the upper quadrant of the breast. This is highly suspicious for a malignant mass. Benign calcific foci are noted again in the right breast.
Caption: Ultrasound of the palpable mass in the left breast
Description: The sonogram demonstrated a hyperechoic mass with heterogeneous internal echoes.
Differential Diagnosis Angiosarcoma, spindle cell tumor, lipoma
Final Diagnosis Low grade angiosarcoma
Discussion • Angiosarcoma is one of the commonest non phyllodes primary breast sarcomas. The latter group only accounts for less than 1 percent of breast malignancies.
• The majority of studies show a strong relationship between this tumor and prior radiation therapy with a large percentage occurring after breast conservation with radiation.
• There are no specific imaging signs for the diagnosis of these tumors
Follow Up Core biopsy was performed with subsequent excisional biopsy. Pathology demonstrated a low grade angiosarcoma.
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