Wu WP, Lee CW. Magnetic resonance imaging findings of radiation-induced breast angiosarcoma: A case report. World J Clin Cases 2024; 12(13): 2237-2242 [DOI: 10.12998/wjcc.v12.i13.2237]
Corresponding Author of This Article
Chih-Wei Lee, MD, Doctor, Department of Radiology, Changhua Christian Medical Foundation Changhua Christian Hospital, No. 135 Nanhsiao Street, Changhua 50006, Taiwan. 133559@cch.org.tw
Research Domain of This Article
Oncology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. May 6, 2024; 12(13): 2237-2242 Published online May 6, 2024. doi: 10.12998/wjcc.v12.i13.2237
Magnetic resonance imaging findings of radiation-induced breast angiosarcoma: A case report
Wen-Pei Wu, Chih-Wei Lee
Wen-Pei Wu, Department of Medical Imaging, Changhua Christian Hospital, Changhua 50006, Taiwan
Chih-Wei Lee, Department of Radiology, Changhua Christian Medical Foundation Changhua Christian Hospital, Changhua 50006, Taiwan
Author contributions: Lee CW designed the research; Wu WP performed the research; Wu WP and Lee CW contributed new reagents/analytic tools; Wu WP and Lee CW analyzed the data; Wu WP and Lee CW wrote the paper.
Informed consent statement: Informed consent was obtained from the individual in this case report prior to study.
Conflict-of-interest statement: All authors declare that they have no conflicts of interest relevant to this case report.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chih-Wei Lee, MD, Doctor, Department of Radiology, Changhua Christian Medical Foundation Changhua Christian Hospital, No. 135 Nanhsiao Street, Changhua 50006, Taiwan. 133559@cch.org.tw
Received: November 26, 2023 Peer-review started: November 26, 2023 First decision: February 5, 2024 Revised: February 17, 2024 Accepted: April 3, 2024 Article in press: May 6, 2024 Published online: May 6, 2024
Abstract
BACKGROUND
Breast conservation surgery (BCS) with adjuvant radiotherapy has become a gold standard in the treatment of early-stage breast cancer, significantly reducing the risk of tumor recurrence. However, this treatment is associated with adverse effects, including the rare but aggressive radiation-induced angiosarcoma (RIAS). Despite its rarity and nonspecific initial presentation, RIAS presents a challenging diagnosis, emphasizing the importance of imaging techniques for early detection and accurate diagnosis.
CASE SUMMARY
We present a case of a 48-year-old post-menopausal woman who developed skin ecchymosis on the right breast seven years after receiving BCS and adjuvant radiotherapy for breast cancer. Initial mammography and ultrasound were inconclusive, showing post-treatment changes but failing to identify the underlying angiosarcoma. Contrast-enhanced breast magnetic resonance imaging (MRI) revealed diffuse skin thickening and nodularity with distinctive enhancement kinetics, leading to the diagnosis of RIAS. This case highlights the crucial role of MRI in diagnosing and determining the extent of RIAS, facilitating timely and appropriate surgical intervention.
CONCLUSION
Breast MRI is crucial for detecting RIAS, especially when mammography and ultrasound are inconclusive.
Core Tip: Radiation-induced angiosarcoma (RIAS) of the breast is extremely rare and aggressive complication of the radiotherapy. The diagnosis is difficult clinically, radiologically and even pathologically. Mammography and ultrasound findings of RIAS are nonspecific and may be occult on the initial conventional breast imaging. Breast magnetic resonance imaging can provide better morphologic characterization and extent of disease, which is critical in surgical planning and preventing delays in diagnosis.
