Postirradiation Angiosarcoma of the Chest Wall and Breast: Issues of Radiogenic Origin, Diagnosis and Treatment in Two CasesPolgár C. · Orosz Z. · Szerdahelyi A. · Fodor J. · Major T. · Mágori A. · Czeyda-Pommersheim F. · Vámosi Nagy I. · Szakolczai I. · Fejös Z. · Németh G.
Departments of aRadiotherapy, bPathology, cGeneral and Thoracic Surgery, dChemotherapy B and eDermatology, National Institute of Oncology, Budapest, Hungary
The authors report two cases of postradiation angiosarcoma (AS) among 5,100 breast cancer patients treated in the period 1980–1994 at the National Institute of Oncology, Budapest. Relevant data in the literature is also reviewed to analyze the questions of radiogenic origin, diagnosis and treatment. Secondary AS occurred in these cases in a previously irradiated field after a 6- and 8-year latency period, respectively. Detailed histopathological and immunohistochemical examinations from the biopsy specimens confirmed the diagnosis as AS. The first patient was treated successfully with radical surgery. The second patient, with unresectable AS, died of rapid local progression within 4 months. The incidence of chest wall and breast AS after radiotherapy was found to be 0.46 per 1,000 in our patient population, which means an estimated odds ratio of 2.9 for secondary AS. Patients treated with radiotherapy for primary breast cancer are at higher risk for developing secondary AS compared to the healthy population. An etiological relationship between radiotherapy and subsequent AS of the chest wall and breast is likely, but still controversial. Initial radical surgery is the only effective treatment for achieving long-term survival. These very rare cases deserve special attention due to the atypical clinical appearance, difficulties of differential diagnosis and poor prognosis.
Csaba Polgár, MD
Department of Radiotherapy, National Institute of Oncology
7–9 Ráth György u.
H–1122 Budapest (Hungary)
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Number of Print Pages : 4
Number of Figures : 3, Number of Tables : 1, Number of References : 13
Oncology (International Journal of Cancer Research and Treatment)
Founded 1948 as ‘Oncologia’ by H.R. Schinz; Continued by V. Richards (1967–1975), H. Wrba (1976–1992)
Vol. 60, No. 1, Year 2001 (Cover Date: Released December 2000)
Journal Editor: P.P. Carbone, Madison, Wisc.
ISSN: 0030–2414 (print), 1423–0232 (Online)
For additional information: http://www.karger.com/journals/onc