Radiation-associated angiosarcoma in the setting of breast cancer mimicking radiation dermatitis: A diagnostic pitfall.
J Cutan Pathol
; 44(5): 456-461, 2017 May.
Article
em En
| MEDLINE
| ID: mdl-28169467
ABSTRACT
BACKGROUND:
We have encountered cases of post-radiation angiosarcoma (PRAS) histologically mimicking radiation dermatitis.METHODS:
Cases of PRAS from institutional/consultation archives from 2006 to 2016 were reviewed. For inclusion, tumors had to have inapparent/subtle tumor at low magnification and scattered individual tumor cells resembling radiation fibroblasts. Prior ancillary studies were reviewed, with additional immunostains performed as needed.RESULTS:
10 cases met criteria. All occurred in women treated for breast cancer (mean age 71 years). All had similarfindings:
in particular, scattered single atypical cells with pleomorphic nuclei associated with microscopic hemorrhage. They also had narrow, slightly wavy "worm-like" vascular channels lined by atypical endothelial cells that lacked architectural complexity. Four cases showed focal areas of more conventional angiosarcoma. One case was an excision of a large mass that showed the "radiation dermatitis-like" pattern radiating out from the central mass. All were positive for vascular markers (CD31, CD34, and/or ERG) and MYC. MYC amplification was demonstrated by FISH in both cases tested. In 3 of 3 cases with available re-excision specimens, more obvious angiosarcoma was seen.CONCLUSIONS:
PRAS can be very subtle and histologically mimic radiation dermatitis. Careful attention to histologic features and ancillary tests allow accurate diagnosis in subtle PRAS.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Radiodermite
/
Neoplasias Cutâneas
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Neoplasias da Mama
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Hemangiossarcoma
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Neoplasias Induzidas por Radiação
Tipo de estudo:
Diagnostic_studies
/
Risk_factors_studies
Limite:
Aged
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Aged80
/
Female
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Humans
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Middle aged
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article