Radiotherapy-associated angiosarcoma in the breast reconstructed by autologous free-flap and treated with electrochemotherapy.


Journal

Radiology and oncology
ISSN: 1581-3207
Titre abrégé: Radiol Oncol
Pays: Poland
ID NLM: 9317213

Informations de publication

Date de publication:
29 12 2020
Historique:
entrez: 22 4 2021
pubmed: 23 4 2021
medline: 21 9 2021
Statut: epublish

Résumé

Radiotherapy-associated angiosarcoma (RAA) of the breast is a rare complication of radiotherapy, which is often difficult to identify and has poor prognosis. It usually presents as violaceous skin, erythema or rapidly growing palpable firm mass that can be confused with other benign skin lesions. After reviewing the literature, we found only four cases with RAA after mastectomy and autologous breast reconstruction. The presented case is the first that was treated by electrochemotherapy. The patient presented with secondary angiosarcoma of the breast five years after mastectomy, immediate breast reconstruction with deep inferior epigastric artery perforator free flap and adjuvant radiotherapy. Electrochemotherapy was feasible, safe and effective in treatment of radiation induced sarcoma. Most of the treated lesions in several consecutive electrochemotherapy sessions responded with complete response, but multiple recurrences occurred in non-treated areas. Patients with breast cancer after skin-sparing mastectomy and immediate breast reconstruction, who receive radiotherapy, need regular long-term follow up and low threshold for biopsy of any suspicious lesions is mandatory. Electrochemotherapy proved as one of feasible modalities of treatment for RAA.

Sections du résumé

BACKGROUND
Radiotherapy-associated angiosarcoma (RAA) of the breast is a rare complication of radiotherapy, which is often difficult to identify and has poor prognosis. It usually presents as violaceous skin, erythema or rapidly growing palpable firm mass that can be confused with other benign skin lesions.
PATIENTS AND METHODS
After reviewing the literature, we found only four cases with RAA after mastectomy and autologous breast reconstruction. The presented case is the first that was treated by electrochemotherapy. The patient presented with secondary angiosarcoma of the breast five years after mastectomy, immediate breast reconstruction with deep inferior epigastric artery perforator free flap and adjuvant radiotherapy.
RESULTS
Electrochemotherapy was feasible, safe and effective in treatment of radiation induced sarcoma. Most of the treated lesions in several consecutive electrochemotherapy sessions responded with complete response, but multiple recurrences occurred in non-treated areas.
CONCLUSIONS
Patients with breast cancer after skin-sparing mastectomy and immediate breast reconstruction, who receive radiotherapy, need regular long-term follow up and low threshold for biopsy of any suspicious lesions is mandatory. Electrochemotherapy proved as one of feasible modalities of treatment for RAA.

Identifiants

pubmed: 33885245
pii: raon-2020-0074
doi: 10.2478/raon-2020-0074
pmc: PMC7877258
doi:

Types de publication

Case Reports Journal Article Research Support, Non-U.S. Gov't Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

77-81

Informations de copyright

© 2021 Romi Cencelj-Arnez, Jerica Novak, Andreja Klevisar Ivancic, Masa Bosnjak, Maja Cemazar, Marko Snoj, published by Sciendo.

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Auteurs

Romi Cencelj-Arnez (R)

Department of Surgical Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia.
Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.

Jerica Novak (J)

Department of Surgical Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia.
Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.

Andreja Klevisar Ivancic (A)

Department of Pathology, Institute of Oncology Ljubljana, Ljubljana, Slovenia.

Masa Bosnjak (M)

Department of Experimental Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia.

Maja Cemazar (M)

Department of Experimental Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia.
University of Primorska, Faculty of Health Sciences, Izola, Slovenia.

Marko Snoj (M)

Department of Surgical Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia.
Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.

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