J Korean Surg Soc.  2012 Apr;82(4):251-255. 10.4174/jkss.2012.82.4.251.

A case report of primary breast angiosarcoma with fatal pulmonary hemorrhage due to thrombocytopenia

• Kim YS
• Kim YJ
• Yim KI
• Park WC

• KMID: 1820074
• DOI: http://doi.org/10.4174/jkss.2012.82.4.251

Abstract

Primary angiosarcomas of the breast are rare malignancy that account for fewer than 0.04% of all malignant breast tumors. The prognosis is poor. Surgery is the first line of treatment for angiosarcoma. Adjuvant chemotherapy and radiotherapy have been tried, but their efficacy remains controversial. Here we present the case of a 47-year-old woman with a palpable left breast mass that was diagnosed as a primary angiosarcoma. The patient underwent modified radical mastectomy with adjuvant chemotherapy and radiotherapy. Postoperatively, eighteen months later, the angiosarcoma recurred. The patient returned complaining of dyspnea and hemoptysis and was found to have a large pleural effusion. She developed a gradual onset of thrombocytopenia that persisted despite platelet transfusions. Finally, the patient died of respiratory failure secondary to pulmonary hemorrhage.

Keyword

Angiosarcoma; Breast neoplasms; Thrombocytopenia

MeSH Terms

Breast
Breast Neoplasms
Chemotherapy, Adjuvant
Dyspnea
Female
Hemangiosarcoma
Hemoptysis
Hemorrhage
Humans
Mastectomy, Modified Radical
Middle Aged
Platelet Transfusion
Pleural Effusion
Prognosis
Respiratory Insufficiency
Thrombocytopenia
Breast Neoplasms
Hemangiosarcoma

Figure

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  Fig. 1 Sonography and magnetic resonance imaging revealed irregular spiculated mass in left breast.

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  Fig. 2 (A) Epithelioid areas of angiosarcoma (H&E, ×400). (B) Spindle vasoformative growth areas of angiosarcoma (H&E, ×400). (C) CD34 immunohistochemical staining results shows diffuse strong positive in tumor cells (×400).

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  Fig. 3 (A) Chest X-ray showed large amount of pleural effusion in left side and mediastinal shifting to right side. (B) Chest X-ray showed secreased amount of pleural effusion in left side.

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  Fig. 4 (A) Chest computed tomography showed pulmonary hemorrhage in left side and pleural effusion in right side. (B) Recurrent angiosarcoma was observed in left chest wall.

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