Primary breast angiosarcoma: on MRI

Case contributed by Dr Enrico Citarella

Presentation

Screening in high risk patient for family history. BRCA unknown. Known fibroadenoma. No prior breast surgery or radiotherapy.

Patient Data

Age: 50
Gender: Female
MRI

Breast MRI (right)

Mass lesion enhancing in the lower outer quadrant with irregular margins. Enhancement curve is type 2 (plateau). The lesion shows hyperintensity in DWI acquisitions.

The lesion shows subtle alterations in pre contrast sequences (very faint hypointensity on T1 weighted images and very faint hyperintensity on STIR images).

Pathology

Biopsy specimens

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 echography. Patient underwent an MRI guided biopsy that resulted in diagnosis of well differentiated angiosarcoma.

Another interesting feature of the lesion is that only very subtle findings in T1 and STIR pre contrast imaging were present while an intense post contrast enhancement was shown.

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

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Case information

rID: 35224
Case created: 27th Mar 2015
Last edited: 10th Dec 2016
System: Breast
Inclusion in quiz mode: Included

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