Angiosarcoma primario y secundario de mama: estudio de 8 casos con evidencia de origen linfático en los angiosarcomas posradioterapia / Primary and secondary angiosarcoma of the breast. A study of 8 cases with evidence of a lymphatic origin in post-radiation angiosarcomas

RESUMEN

Objetivo. Analizar las diferencias entre los angiosarcomas primarios y posradioterapia de mama. Pacientes y métodos. Revisamos retrospectivamente angiosarcomas de mama entre los años 2000 y 2010. Realizamos un estudio clinicopatológico e inmunohistoquímico con CKAE1/AE3, CD31, CD34, Ki-67, D2-40. Resultados. Se incluyeron 8 mujeres, 4 con angiosarcomas primarios y 4 secundarios. La edad media era de 66 años en los primarios y de 74 en los secundarios. El periodo de latencia medio posradioterapia en los angiosarcomas secundarios fue de 118 meses. Tres tumores secundarios afectaban la piel, 3 angiosarcomas primarios eran intraparenquimatosos y los 2 restantes fueron mixtos. Todos los casos fueron CD31+/CD34+/CKAE1/AE3−. Los angiosarcomas secundarios expresaron el marcador linfático D2-40, mientras que los primarios eran D2-40−. Conclusiones. Los angiosarcomas secundarios expresan D2-40, mientras que los primarios son negativos para este marcador. Ello evidencia un origen vascular linfático para los angiosarcomas posradioterapia (AU)

ABSTRACT

Objective. To analyze differences between primary and radiation-associated secondary breast angiosarcomas. Patients and methods. We retrospectively reviewed all cases of angiosarcoma diagnosed at our hospital between 2000 and 2010. We analyzed the clinical and pathological features. In the immunohistochemical study, we assessed expression of CKAE1/AE3, CD31, CD34, Ki-67 and D2-40. Results. There were 8 women, 4 with primary angiosarcoma and 4 with secondary angiosarcoma. The mean age at presentation was 66 years for primary tumors and 74 years for secondary angiosarcomas. The mean latency period for radiation-associated angiosarcomas was 118 months. Three secondary tumors involved the skin, 3 primary angiosarcomas were intramammary and the remaining 2 were mixed. All tumors were CD31+/CD34+/CKAE1/AE3−. The secondary angiosarcomas also expressed D2-40, while the primary tumors were negative for this lymphatic marker. Conclusions. Secondary angiosarcomas express D2-40, while primary angiosarcomas are negative for this lymphatic marker. This finding suggests a lymphatic origin for post-radiation angiosarcomas (AU)