Angiosarcoma (hæmangioblastoma) of the breast

Angiosarcoma of the breast

A case of angiosarcoma of the breast with a fatal outcome is reported, and the world literature on this rare type of breast tumor is reviewed. Familiarity with the clinical and pathologic features of this entity is essential in avoiding underdiagnosis and delay of definitive treatment. The three-year survival rate of reported cases was 38%. However, the three-year, disease-free survival was only 14%. Five cases with five-year, disease-free survival have been reported to date. Eighteen patients (21%) showed contralateral breast involvement; in half of these, it occurred before other evidence of tumor dissemination. Simple mastectomy appears to be the optimal treatment of choice, since axillary node involvement is extremely rare. The role of irradiation and chemotherapy as adjuvant therapy remains to be evaluated.

Vascular tumors in the region of the breast

Three vascular tumors in the breast region with different degrees of differentiation are presented. The first neoplasm is a haemangiosarcoma (of the vascular neoplasms, these tumors are the type which occur most frequently in the breast). Haemangiosarcomas show an infiltrative growth of atypical blood capillaries, frequently with formation of highly cellular and solid capillary sprouts. Ultrastructurally, the tumor cells are characterized as endothelial, also in the region of the capillary sprouts. The second tumor (an angiosarcoma in Stewart-Treves-syndrome, STS) is characterized by an intensive endothelial proliferation. Solid spindle-celled regions are also found in which the tumor cells correspond to undifferentiated mesenchymal cells, but other cells possessing properties of smooth muscle cells and pericytes may be found. The third tumor corresponds light and electron microscopically to a haemangiopericytoma of the soft tissue. The pericytic character of the tumor cells is most clearly seen in the immediate vicinity of the vessels. With increasing distance from the capillaries, the tumor cells take on the characteristics of fibroblasts. The tumors reflect the diversity of the angioplastic differentiation potential of the mesenchyme.

[On the relation between lobular angiomatosis and angiosarcomas of the breast (author's transl)]

A 38 year old woman showed first a lobular angiomatosis of the breast with regular neoplastic capillaries. After about one year multiple nodules of an agniosarcoma appeared. Their origin from the angiomatosis is suggested by the sequence of the lesions and for topical and histogenetic reasons.

Haemangiosarcoma of breast

This is a report of a haemangiosarcoma involving the breast, spleen, liver, lungs, and subcutaneous tissue. There appears to be evidence that the tumour arose in the breast with the other sites representing metastases rather than a malignant transformation of multiple haemangiomatoses. Histologically the primary breast tumour appeared deceptively innocuous.