Potential characteristic image findings of primary angiosarcoma of the breast: A case report

Angiosarcomas of the breast are a rare and extremely aggressive tumor of vascular origin comprising 0.04% of all malignant neoplasms of the breast. Quickly progressing and the poorer prognosis requires early diagnosis. A 37-year-old woman had a painful swelling in her left breast. A core biopsy confirmed an atypical vascular lesion. She was referred to our hospital suspected primary angiosarcoma. A hard tumor 100 × 50 mm in size was palpated in the upper outer quadrant of her left breast. Mammography could not be attempted due to pain. Ultrasound showed an oval tumor with relatively clear margins and heterogeneous internal echoes including hyperechoic foci. Magnetic resonance images (MRI) showed heterogeneous hypo- and hyper-intensity on T1-weighted and T2-weighted images from hematomas. Nipple-sparing mastectomy was attempted as a surgical excision. Histopathological analysis reaffirmed well differentiated angiosarcoma of the breast. Following surgical resection, the patient underwent adjuvant chemotherapy with paclitaxel administered weekly for 12 cycles, and she has survived without recurrence for 3 years after surgery. We propose characteristics of ultrasound and MRI from histological images; diagnostic physicians should note that various characteristics on imaging modalities for angiosarcomas of the breast.