Primary breast angiosarcoma (MRI)

Case contributed by Dr Enrico Citarella

Presentation

Surveillance MRI performed in view of strong for family history for breast carcinoma. BRCA unknown. Known fibroadenoma. No prior breast surgery or radiotherapy.

Patient Data

Age: 50 years
Gender: Female

Breast MRI (right)

MRI

Right breast mass in the lower outer quadrant with irregular margins. It is demonstrated subtle hypointensity in T1 and STIR, and hyperintense in DWI acquisitions. It also enhances and demonstrates a type 2 curve (plateau) in post-contrast sequences.

Biopsy specimens

Pathology

Well differentiated angiosarcoma of breast.

Case Discussion

Primary breast angiosarcoma is a rare neoplasm. (~0.04% of all breast cancers).

In this particular case is noteworthy that lesion was not detectable at the second look sonography. The patient underwent an MRI guided biopsy that resulted in a diagnosis of well-differentiated angiosarcoma.

Another interesting feature of this mass is, it demonstrates very subtle findings in T1 and STIR pre-contrast imaging. In post contrast sequences, it demonstrates an intense enhancement.

Although the tumor is well differentiated it has to be considered of aggressive nature. 

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