Primary epithelioid angiosarcoma of the breast masquerading as carcinoma
Identifieur interne : 002181 ( Pmc/Curation ); précédent : 002180; suivant : 002182Primary epithelioid angiosarcoma of the breast masquerading as carcinoma
Auteurs : S. Muzumder [Inde] ; P. Das [Inde] ; M. Kumar [Inde] ; S. Bhasker [Inde] ; C. Sarkar [Inde] ; K. Medhi [Inde] ; V. K. Iyer [Inde] ; G. K. Rath [Inde]Source :
- Current Oncology [ 1198-0052 ] ; 2010.
Abstract
Here we report a case of primary epithelioid angiosarcoma (
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PubMed: 20179806
PubMed Central: 2826780
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Primary epithelioid angiosarcoma of the breast masquerading as carcinoma</title><author><name sortKey="Muzumder, S" sort="Muzumder, S" uniqKey="Muzumder S" first="S." last="Muzumder">S. Muzumder</name><affiliation wicri:level="1"><nlm:aff id="af1-conc17-1-64"> Department of Radiotherapy, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea> Department of Radiotherapy, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi</wicri:regionArea></affiliation></author><author><name sortKey="Das, P" sort="Das, P" uniqKey="Das P" first="P." last="Das">P. Das</name><affiliation wicri:level="1"><nlm:aff id="af2-conc17-1-64"> Department of Pathology, All India Institute of Medical Sciences, New Delhi, India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea> Department of Pathology, All India Institute of Medical Sciences, New Delhi</wicri:regionArea></affiliation></author><author><name sortKey="Kumar, M" sort="Kumar, M" uniqKey="Kumar M" first="M." last="Kumar">M. Kumar</name><affiliation wicri:level="1"><nlm:aff id="af1-conc17-1-64"> Department of Radiotherapy, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea> Department of Radiotherapy, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi</wicri:regionArea></affiliation></author><author><name sortKey="Bhasker, S" sort="Bhasker, S" uniqKey="Bhasker S" first="S." last="Bhasker">S. Bhasker</name><affiliation wicri:level="1"><nlm:aff id="af1-conc17-1-64"> Department of Radiotherapy, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea> Department of Radiotherapy, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi</wicri:regionArea></affiliation></author><author><name sortKey="Sarkar, C" sort="Sarkar, C" uniqKey="Sarkar C" first="C." last="Sarkar">C. Sarkar</name><affiliation wicri:level="1"><nlm:aff id="af2-conc17-1-64"> Department of Pathology, All India Institute of Medical Sciences, New Delhi, India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea> Department of Pathology, All India Institute of Medical Sciences, New Delhi</wicri:regionArea></affiliation></author><author><name sortKey="Medhi, K" sort="Medhi, K" uniqKey="Medhi K" first="K." last="Medhi">K. Medhi</name><affiliation wicri:level="1"><nlm:aff id="af3-conc17-1-64"> Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea> Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi</wicri:regionArea></affiliation></author><author><name sortKey="Iyer, V K" sort="Iyer, V K" uniqKey="Iyer V" first="V. K." last="Iyer">V. K. Iyer</name><affiliation wicri:level="1"><nlm:aff id="af2-conc17-1-64"> Department of Pathology, All India Institute of Medical Sciences, New Delhi, India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea> Department of Pathology, All India Institute of Medical Sciences, New Delhi</wicri:regionArea></affiliation></author><author><name sortKey="Rath, G K" sort="Rath, G K" uniqKey="Rath G" first="G. K." last="Rath">G. K. Rath</name><affiliation wicri:level="1"><nlm:aff id="af1-conc17-1-64"> Department of Radiotherapy, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea> Department of Radiotherapy, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">20179806</idno><idno type="pmc">2826780</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2826780</idno><idno type="RBID">PMC:2826780</idno><date when="2010">2010</date><idno type="wicri:Area/Pmc/Corpus">002182</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002182</idno><idno type="wicri:Area/Pmc/Curation">002181</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">002181</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Primary epithelioid angiosarcoma of the breast masquerading as carcinoma</title><author><name sortKey="Muzumder, S" sort="Muzumder, S" uniqKey="Muzumder S" first="S." last="Muzumder">S. Muzumder</name><affiliation wicri:level="1"><nlm:aff id="af1-conc17-1-64"> Department of Radiotherapy, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea> Department of Radiotherapy, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi</wicri:regionArea></affiliation></author><author><name sortKey="Das, P" sort="Das, P" uniqKey="Das P" first="P." last="Das">P. Das</name><affiliation wicri:level="1"><nlm:aff id="af2-conc17-1-64"> Department of Pathology, All India Institute of Medical Sciences, New Delhi, India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea> Department of Pathology, All India Institute of Medical Sciences, New Delhi</wicri:regionArea></affiliation></author><author><name sortKey="Kumar, M" sort="Kumar, M" uniqKey="Kumar M" first="M." last="Kumar">M. Kumar</name><affiliation wicri:level="1"><nlm:aff id="af1-conc17-1-64"> Department of Radiotherapy, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea> Department of Radiotherapy, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi</wicri:regionArea></affiliation></author><author><name sortKey="Bhasker, S" sort="Bhasker, S" uniqKey="Bhasker S" first="S." last="Bhasker">S. Bhasker</name><affiliation wicri:level="1"><nlm:aff id="af1-conc17-1-64"> Department of Radiotherapy, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea> Department of Radiotherapy, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi</wicri:regionArea></affiliation></author><author><name sortKey="Sarkar, C" sort="Sarkar, C" uniqKey="Sarkar C" first="C." last="Sarkar">C. Sarkar</name><affiliation wicri:level="1"><nlm:aff id="af2-conc17-1-64"> Department of Pathology, All India Institute of Medical Sciences, New Delhi, India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea> Department of Pathology, All India Institute of Medical Sciences, New Delhi</wicri:regionArea></affiliation></author><author><name sortKey="Medhi, K" sort="Medhi, K" uniqKey="Medhi K" first="K." last="Medhi">K. Medhi</name><affiliation wicri:level="1"><nlm:aff id="af3-conc17-1-64"> Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea> Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi</wicri:regionArea></affiliation></author><author><name sortKey="Iyer, V K" sort="Iyer, V K" uniqKey="Iyer V" first="V. K." last="Iyer">V. K. Iyer</name><affiliation wicri:level="1"><nlm:aff id="af2-conc17-1-64"> Department of Pathology, All India Institute of Medical Sciences, New Delhi, India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea> Department of Pathology, All India Institute of Medical Sciences, New Delhi</wicri:regionArea></affiliation></author><author><name sortKey="Rath, G K" sort="Rath, G K" uniqKey="Rath G" first="G. K." last="Rath">G. K. Rath</name><affiliation wicri:level="1"><nlm:aff id="af1-conc17-1-64"> Department of Radiotherapy, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea> Department of Radiotherapy, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi</wicri:regionArea></affiliation></author></analytic><series><title level="j">Current Oncology</title><idno type="ISSN">1198-0052</idno><idno type="eISSN">1718-7729</idno><imprint><date when="2010">2010</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Here we report a case of primary epithelioid angiosarcoma (<sc>eas</sc>) of the breast occurring in a 30-year-old woman. Following fine-needle asspiration cytology (<sc>fnac</sc>) and tru-cut biopsy, the patient was initially diagnosed with mammary carcinoma and thereafter underwent modified radical mastectomy. Postoperative histopathologic examination and immunohistochemistry revealed a diagnosis of primary epithelioid angiosarcoma of the breast. The patient received postoperative radiotherapy to the chest wall and was started on adjuvant thalidomide. Preoperatively, <sc>eas</sc> can be mistaken for carcinoma because it is difficult to appreciate the typical morphology on <sc>fnac</sc> or tru-cut biopsy. Indeed, this is an area of potential diagnostic error because, nowadays, neoadjuvant therapy is often instituted after core biopsy of a breast mass. 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Curr Oncol</journal-id><journal-id journal-id-type="publisher-id">CO</journal-id><journal-title-group><journal-title>Current Oncology</journal-title></journal-title-group><issn pub-type="ppub">1198-0052</issn><issn pub-type="epub">1718-7729</issn><publisher><publisher-name>Multimed Inc.</publisher-name><publisher-loc>66 Martin St. Milton, ON, Canada L9T 2R2</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">20179806</article-id><article-id pub-id-type="pmc">2826780</article-id><article-id pub-id-type="publisher-id">conc17-1-64</article-id><article-categories><subj-group subj-group-type="heading"><subject>Case Report</subject></subj-group></article-categories><title-group><article-title>Primary epithelioid angiosarcoma of the breast masquerading as carcinoma</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Muzumder</surname><given-names>S.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="af1-conc17-1-64">*</xref><xref ref-type="corresp" rid="c1-conc17-1-64"></xref></contrib><contrib contrib-type="author"><name><surname>Das</surname><given-names>P.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="af2-conc17-1-64">†</xref></contrib><contrib contrib-type="author"><name><surname>Kumar</surname><given-names>M.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="af1-conc17-1-64">*</xref></contrib><contrib contrib-type="author"><name><surname>Bhasker</surname><given-names>S.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="af1-conc17-1-64">*</xref></contrib><contrib contrib-type="author"><name><surname>Sarkar</surname><given-names>C.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="af2-conc17-1-64">†</xref></contrib><contrib contrib-type="author"><name><surname>Medhi</surname><given-names>K.</given-names></name><degrees>DM</degrees><xref ref-type="aff" rid="af3-conc17-1-64">‡</xref></contrib><contrib contrib-type="author"><name><surname>Iyer</surname><given-names>V.K.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="af2-conc17-1-64">†</xref></contrib><contrib contrib-type="author"><name><surname>Rath</surname><given-names>G.K.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="af1-conc17-1-64">*</xref></contrib></contrib-group><aff id="af1-conc17-1-64"><label>*</label> Department of Radiotherapy, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India</aff><aff id="af2-conc17-1-64"><label>†</label> Department of Pathology, All India Institute of Medical Sciences, New Delhi, India</aff><aff id="af3-conc17-1-64"><label>‡</label> Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India</aff><author-notes><corresp id="c1-conc17-1-64">Correspondence to: Sandeep Muzumder, Department of Radiotherapy, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi 110029 India., E-mail:
<email>sandeepradonc@hotmail.com</email></corresp></author-notes><pub-date pub-type="ppub"><month>2</month><year>2010</year></pub-date><volume>17</volume><issue>1</issue><fpage>64</fpage><lpage>69</lpage><permissions><copyright-statement>2010 Multimed Inc.</copyright-statement><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/2.5/"><license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><abstract><p>Here we report a case of primary epithelioid angiosarcoma (<sc>eas</sc>) of the breast occurring in a 30-year-old woman. Following fine-needle asspiration cytology (<sc>fnac</sc>) and tru-cut biopsy, the patient was initially diagnosed with mammary carcinoma and thereafter underwent modified radical mastectomy. Postoperative histopathologic examination and immunohistochemistry revealed a diagnosis of primary epithelioid angiosarcoma of the breast. The patient received postoperative radiotherapy to the chest wall and was started on adjuvant thalidomide. Preoperatively, <sc>eas</sc> can be mistaken for carcinoma because it is difficult to appreciate the typical morphology on <sc>fnac</sc> or tru-cut biopsy. Indeed, this is an area of potential diagnostic error because, nowadays, neoadjuvant therapy is often instituted after core biopsy of a breast mass. This case is being reported not only for its diagnostic difficulty, but also because of its rarity in English literature.</p></abstract><kwd-group><kwd>Breast</kwd><kwd>primary epithelioid angiosarcoma</kwd></kwd-group></article-meta></front><floats-group><fig id="f1-conc17-1-64" position="float"><label>FIGURE 1</label><caption><p>(a,b) Fine-needle aspiration cytology of the breast lesion showed singly-lying epithelioid cells with irregular pleomorphic nuclei and moderate-to-abundant bluish cytoplasm [Giemsa stain: (a) 200×, (b) 400×]. (c,d) Tru-cut biopsy of the breast showed irregular cords and singly-lying pleomorphic cells with moderate cytoplasm and focal necrosis [hematoxylin and eosin stain: (c) 40×, (d) 100×]. (d, inset) The cells were immunopositive for cytokeratin (40×).</p></caption><graphic xlink:href="conc17-1-64f1"></graphic></fig><fig id="f2-conc17-1-64" position="float"><label>FIGURE 2</label><caption><p>(a) Low-power photomicrograph of the resected tissue shows an infiltrating malignant tumour entrapping the residual ductules (hematoxylin and eosin stain, 40×). (b) The tumour is highly vascular, comprising many large and slit-like vascular spaces (hematoxylin and eosin stain, 200×). (c) The slit-like spaces are lined by pleomorphic epithelioid malignant cells. Few giant cells are noted (hematoxylin and eosin stain, 400×). (d) The tumour cells are strongly immunopositive for CD31 (200×). (d, inset) Immunostaining for the human epidermal growth factor receptor (<sc>her</sc>2/<italic>neu</italic>) was positive in tumour cells (200×).</p></caption><graphic xlink:href="conc17-1-64f2"></graphic></fig><table-wrap id="tI-conc17-1-64" position="float"><label>TABLE I</label><caption><p>Cases of primary epithelioid angiosarcoma of the breast<xref ref-type="table-fn" rid="tfn1-conc17-1-64">a</xref></p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" valign="top" rowspan="2" colspan="1">Reference</th><th colspan="2" align="center" rowspan="1">Patient</th><th align="center" valign="top" rowspan="2" colspan="1">Treatment</th><th align="center" valign="top" rowspan="2" colspan="1">Immunohistochemistry [positive (+), negative (−)]</th><th align="center" valign="top" rowspan="2" colspan="1">Outcome</th></tr><tr><th align="center" rowspan="1" colspan="1">Age (years)</th><th align="center" rowspan="1" colspan="1">Sex</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">Martinez <italic>et al.,</italic> 1997<xref ref-type="bibr" rid="b13-conc17-1-64">13</xref></td><td align="center" rowspan="1" colspan="1">26</td><td align="center" rowspan="1" colspan="1">F</td><td align="center" rowspan="1" colspan="1">Modified radical mastectomy, postoperative radiotherapy (4860 cGy), doxorubicin and dacarbazine</td><td align="center" rowspan="1" colspan="1">Vimentin+, factor <sc>viii</sc>+, CD31+, cytokeratin−</td><td align="center" rowspan="1" colspan="1">Alive at 7 months, with local recurrence</td></tr><tr><td align="left" rowspan="1" colspan="1">Farina <italic>et al.,</italic> 2003<xref ref-type="bibr" rid="b14-conc17-1-64">14</xref></td><td align="center" rowspan="1" colspan="1">49</td><td align="center" rowspan="1" colspan="1">F</td><td align="center" rowspan="1" colspan="1">Modified radical mastectomy, no adjuvant</td><td align="center" rowspan="1" colspan="1">Vimentin+, factor <sc>viii</sc>+, CD31+, CD34+, cytokeratin−</td><td align="center" rowspan="1" colspan="1">Died at 15 months of metastasis</td></tr><tr><td align="left" rowspan="1" colspan="1">Carter <italic>et al.,</italic> 2005<xref ref-type="bibr" rid="b15-conc17-1-64">15</xref></td><td align="center" rowspan="1" colspan="1">33</td><td align="center" rowspan="1" colspan="1">F</td><td align="center" rowspan="1" colspan="1">Simple mastectomy, no adjuvant</td><td align="center" rowspan="1" colspan="1"><sc>nr</sc></td><td align="center" rowspan="1" colspan="1">Alive at 7 months, with axillary recurrence</td></tr><tr><td align="left" rowspan="1" colspan="1">Wang <italic>et al.,</italic> 2007<xref ref-type="bibr" rid="b16-conc17-1-64">16</xref></td><td align="center" rowspan="1" colspan="1">20</td><td align="center" rowspan="1" colspan="1">M</td><td align="center" rowspan="1" colspan="1">Complete excision, no adjuvant</td><td align="center" rowspan="1" colspan="1">Vimentin+, factor <sc>viii</sc>+, CD31+, CD34+, cytokeratin+</td><td align="center" rowspan="1" colspan="1">Died at 6 months of metastasis</td></tr><tr><td align="left" rowspan="1" colspan="1">Muzumder <italic>et al.</italic> (present case)</td><td align="center" rowspan="1" colspan="1">30</td><td align="center" rowspan="1" colspan="1">F</td><td align="center" rowspan="1" colspan="1">Modified radical mastectomy, postoperative radiotherapy (5000 cGy), thalidomide</td><td align="center" rowspan="1" colspan="1">Vimentin+, CD31+, CD34−, <sc>her</sc>2/<italic>neu</italic> (erbB-2)+, <sc>er</sc>−, <sc>pr</sc>−, cytokeratin−</td><td align="center" rowspan="1" colspan="1">Alive at 9 months, free of disease; on thalidomide</td></tr></tbody></table><table-wrap-foot><fn id="tfn1-conc17-1-64"><label>a</label><p>Excludes cases mentioned by Nascimento <italic>et al.,</italic> 2008.<xref ref-type="bibr" rid="b3-conc17-1-64">3</xref></p></fn><fn id="tfn2-conc17-1-64"><p>F = female; M = male; <sc>nr</sc> = not reported; <sc>her</sc>2/<italic>neu</italic> = human epidermal growth factor receptor; <sc>er</sc> = estrogen receptor; <sc>pr</sc> = progesterone receptor.</p></fn></table-wrap-foot></table-wrap></floats-group></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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