Angiossarcoma induzido por radiação: relato de caso

Danilo Rafael da Silva Fontinele Autor correspondente: Danilo Rafael da Silva Fontinele, Rua Olavo Bilac, 2.335 CEP: 64045-420 – Teresina, PI, Brasil. Tel.: (86) 3221-4749 E-mail: drsilvafontinele@gmail.com

Universidade Estadual do Piauí, Teresina, PI, Brasil.

http://orcid.org/0000-0001-8754-6871

Sabas Carlos Vieira

Universidade Federal do Piauí, Teresina, PI, Brasil.

http://orcid.org/0000-0003-0935-7316

Autor correspondente: Danilo Rafael da Silva Fontinele, Rua Olavo Bilac, 2.335 CEP: 64045-420 – Teresina, PI, Brasil. Tel.: (86) 3221-4749 E-mail: drsilvafontinele@gmail.com

Figuras (4)
Tabelas (1)

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Figura 1
Lesões róseas e violáceas, sendo uma localizada na junção do quadrante superior (A) e outra na junção do quadrante inferior, medindo 0,5cm (B)

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Figura 2
Anatomia patológica

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Figura 3
Espécimes obtidas da lesão da pele ressecada na junção do quadrante superior e junção de quadrante inferior da mama direita

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Figura 4
Estudo imuno-histoquímico mostrando resultado positivo para (A) grupo de diferenciação 31 e (B) c-Myc oncogene

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Tabela 1
Angiossarcoma de mama induzido por radiação após tratamento para câncer de mama⁽¹⁵15. Abbenante D, Malosso M, Raone B. Radiation-induced cutaneous angiosarcoma of the breast. Am J Med. 2020;33(10):1156-7.

16. Shiraki E, Kang Y, Shibayama T, Tsuyuki S. Two cases of breast angiosarcoma after breast conserving surgery. Surg Case Rep. 2020;6(1):81.

17. Jayarajah U, Nagodavithane K, Basnayake O, Seneviratne S. Unusual Presentation of Bilateral Radiation-Induced Angiosarcoma of the Breast. Case Rep Oncol Med. 2020;5768438. doi: 10.1155/2020/5768438.
https://doi.org/10.1155/2020/5768438...

18. Lewcun JA, Pameijer C, Kass R, Cream L, Hershock D, Brooks AJ, et al. Dodge DG. Doxorubicin, paclitaxel, and cisplatin based chemotherapy for the treatment of angiosarcoma: two case reports. Int J Surg Case Rep. 2020;68:83-7.

19. Kong J, Shahait AD, Kim S, Choi L. Radiation-induced undifferentiated pleomorphic sarcoma of the breast. BMJ Case Rep. 2020;13(2): e232616.

20. Suzuki Y, Taniguchi K, Hatono M, Kajiwara Y, Abe Y, Kawada K, et al. Recurring radiation-induced angiosarcoma of the breast that was treated with paclitaxel chemotherapy: a case report. Surg Case Rep. 2020;6(1):25.

21. Amajoud Z, Vertongen AS, Weytens R, Hauspy J. Radiation induced angiosarcoma of the breast: case series and review of the literature. Facts Views Vis Obgyn. 2018;10(4):215-20.

22. Lee H, MacDonald SM. Multifocal angiosarcoma secondary to partial breast irradiation: reirradiate? Int J Radiat Oncol Biol Phys. 2019:105(1):17-18.

23. Verdura V, Di Pace B, Concilio M, Guastafierro A, Fiorillo G, Alfano L, et al. A new case of radiation-induced breast angiosarcoma. Int J Surg Case Rep. 2019;60:152-5.

24. Tsapralis N, Vlachogiorgos A, Pham H, Mowatt D. Nothing is impossible: radiation induced angiosarcoma of breast in a male patient. J Surg Case Rep. 2019;2019(5):rjz158.

25. Wei NJ, Crowley TP, Ragbir M. Early breast angiosarcoma development after radiotherapy. Ann Plast Surg. 2019;83(2):152-3.

26. García Novoa A, Acea Nebril B, Bouzón Alejandro A, Cereijo Garea C, Antolín Novoa S. Radiation-induced angiosarcoma of the breast in a Li-Fraumeni patient. Cir Esp. 2019;97(2):114-6.

27. Bonzano E, Guenzi M, Corvò R. Salvage hypofractionated radiotherapy in a progressive radiation-induced angiosarcoma: a case report. Cureus. 2017;9(11):e1886.

28. Farran Y, Padilla O, Chambers K, Philipovskiy A, Nahleh Z. Atypical Presentation of Radiation-Associated Breast Angiosarcoma: a case report and review of literature. Am J Case Rep. 2017;18:1347-50.

29. Disharoon M, Kozlowski KF, Kaniowski JM. Case 242: radiation-induced angiosarcoma. Radiology. 2017;283(3):909-16.

30. Plichta JK, Hughes K. Radiation-Induced angiosarcoma after breast-cancer treatment. N Engl J Med. 2017;376(4):367.

31. Tato-Varela S, Albalat-Fernández R, Pabón-Fernández S, Núñez-García D, Calle-Marcos M. Radiation-induced breast angiosarcoma: a case report. Ecancermedicalscience. 2016;10:697.

32. Wronski K, Frackowiak L. Angiosarcoma following radiation therapy for breast cancer case report. Ann Ital Chir. 2016;5:S2239253X16025032.

33. Wilhelm IN, Penman EJ. Radiation associated angiosarcoma: case series from a community cancer center and review of the literature. Del Med J. 2016;88(3):78-82.

34. Mocerino C, Iannaci G, Sapere P, Luise R, Canonico S, Gambardella A. Multidisciplinary approach to breast angiosarcoma in an elderly patient: Repeated local relapses and significant objective responses. Int J Immunopathol Pharmacol. 2016;29(3):537-42.

35. Peterson CB, Beauregard S. Radiation-induced breast angiosarcoma: case report and clinical approach. J Cutan Med Surg. 2016;20(4):304-7.

36. Tidwell WJ, Haq J, Kozlowski KF, Googe PB. C-MYC positive angiosarcoma of skin and breast following MammoSite®treatment. Dermatol Online J. 2015;21(10):13030 /qt4t65q9nc.

37. Uryvaev A, Moskovitz M, Abdach-Bortnyak R, Hershkovitz D, Fried G. Post-irradiation angiosarcoma of the breast: clinical presentation and outcome in a series of six cases. Breast Cancer Res Treat. 2015;153(1):3-8.

38. Parvez E, Popovic S, Elavathil L, Okawara G, Hodgson N. Early occurrence of angiosarcoma in a woman with a brca2 gene variation of unknown significance treated with breast-conserving therapy for bilateral ductal carcinoma: a case report. Clin Breast Cancer. 2015;15(6):536-8.^-³⁹39. Styring E, Klasson S, Rydholm A, Vult von Steyern F. Radiation-associated angiosarcoma after breast cancer: Improved survival by excision of all irradiated skin and soft tissue of the thoracic wall? A report of six patients. Acta Oncol. 2015;54(7):1078-80.⁾

Tabela 1 Angiossarcoma de mama induzido por radiação após tratamento para câncer de mama⁽¹⁵15. Abbenante D, Malosso M, Raone B. Radiation-induced cutaneous angiosarcoma of the breast. Am J Med. 2020;33(10):1156-7.

16. Shiraki E, Kang Y, Shibayama T, Tsuyuki S. Two cases of breast angiosarcoma after breast conserving surgery. Surg Case Rep. 2020;6(1):81.

17. Jayarajah U, Nagodavithane K, Basnayake O, Seneviratne S. Unusual Presentation of Bilateral Radiation-Induced Angiosarcoma of the Breast. Case Rep Oncol Med. 2020;5768438. doi: 10.1155/2020/5768438.
https://doi.org/10.1155/2020/5768438...

18. Lewcun JA, Pameijer C, Kass R, Cream L, Hershock D, Brooks AJ, et al. Dodge DG. Doxorubicin, paclitaxel, and cisplatin based chemotherapy for the treatment of angiosarcoma: two case reports. Int J Surg Case Rep. 2020;68:83-7.

19. Kong J, Shahait AD, Kim S, Choi L. Radiation-induced undifferentiated pleomorphic sarcoma of the breast. BMJ Case Rep. 2020;13(2): e232616.

20. Suzuki Y, Taniguchi K, Hatono M, Kajiwara Y, Abe Y, Kawada K, et al. Recurring radiation-induced angiosarcoma of the breast that was treated with paclitaxel chemotherapy: a case report. Surg Case Rep. 2020;6(1):25.

21. Amajoud Z, Vertongen AS, Weytens R, Hauspy J. Radiation induced angiosarcoma of the breast: case series and review of the literature. Facts Views Vis Obgyn. 2018;10(4):215-20.

22. Lee H, MacDonald SM. Multifocal angiosarcoma secondary to partial breast irradiation: reirradiate? Int J Radiat Oncol Biol Phys. 2019:105(1):17-18.

23. Verdura V, Di Pace B, Concilio M, Guastafierro A, Fiorillo G, Alfano L, et al. A new case of radiation-induced breast angiosarcoma. Int J Surg Case Rep. 2019;60:152-5.

24. Tsapralis N, Vlachogiorgos A, Pham H, Mowatt D. Nothing is impossible: radiation induced angiosarcoma of breast in a male patient. J Surg Case Rep. 2019;2019(5):rjz158.

25. Wei NJ, Crowley TP, Ragbir M. Early breast angiosarcoma development after radiotherapy. Ann Plast Surg. 2019;83(2):152-3.

26. García Novoa A, Acea Nebril B, Bouzón Alejandro A, Cereijo Garea C, Antolín Novoa S. Radiation-induced angiosarcoma of the breast in a Li-Fraumeni patient. Cir Esp. 2019;97(2):114-6.

27. Bonzano E, Guenzi M, Corvò R. Salvage hypofractionated radiotherapy in a progressive radiation-induced angiosarcoma: a case report. Cureus. 2017;9(11):e1886.

28. Farran Y, Padilla O, Chambers K, Philipovskiy A, Nahleh Z. Atypical Presentation of Radiation-Associated Breast Angiosarcoma: a case report and review of literature. Am J Case Rep. 2017;18:1347-50.

29. Disharoon M, Kozlowski KF, Kaniowski JM. Case 242: radiation-induced angiosarcoma. Radiology. 2017;283(3):909-16.

30. Plichta JK, Hughes K. Radiation-Induced angiosarcoma after breast-cancer treatment. N Engl J Med. 2017;376(4):367.

31. Tato-Varela S, Albalat-Fernández R, Pabón-Fernández S, Núñez-García D, Calle-Marcos M. Radiation-induced breast angiosarcoma: a case report. Ecancermedicalscience. 2016;10:697.

32. Wronski K, Frackowiak L. Angiosarcoma following radiation therapy for breast cancer case report. Ann Ital Chir. 2016;5:S2239253X16025032.

33. Wilhelm IN, Penman EJ. Radiation associated angiosarcoma: case series from a community cancer center and review of the literature. Del Med J. 2016;88(3):78-82.

34. Mocerino C, Iannaci G, Sapere P, Luise R, Canonico S, Gambardella A. Multidisciplinary approach to breast angiosarcoma in an elderly patient: Repeated local relapses and significant objective responses. Int J Immunopathol Pharmacol. 2016;29(3):537-42.

35. Peterson CB, Beauregard S. Radiation-induced breast angiosarcoma: case report and clinical approach. J Cutan Med Surg. 2016;20(4):304-7.

36. Tidwell WJ, Haq J, Kozlowski KF, Googe PB. C-MYC positive angiosarcoma of skin and breast following MammoSite®treatment. Dermatol Online J. 2015;21(10):13030 /qt4t65q9nc.

37. Uryvaev A, Moskovitz M, Abdach-Bortnyak R, Hershkovitz D, Fried G. Post-irradiation angiosarcoma of the breast: clinical presentation and outcome in a series of six cases. Breast Cancer Res Treat. 2015;153(1):3-8.

38. Parvez E, Popovic S, Elavathil L, Okawara G, Hodgson N. Early occurrence of angiosarcoma in a woman with a brca2 gene variation of unknown significance treated with breast-conserving therapy for bilateral ductal carcinoma: a case report. Clin Breast Cancer. 2015;15(6):536-8.^-³⁹39. Styring E, Klasson S, Rydholm A, Vult von Steyern F. Radiation-associated angiosarcoma after breast cancer: Improved survival by excision of all irradiated skin and soft tissue of the thoracic wall? A report of six patients. Acta Oncol. 2015;54(7):1078-80.⁾

Autor	Sexo/idade (ano)	Número de casos	Tratamento de tumor primário	Tamanho do angiossarcoma/tempo de radioterapia anterior	Seguimento (meses)	Resultado	Tratamento para angiossarcoma	Recidiva/tratamento
Abbenante et al.⁽¹⁵15. Abbenante D, Malosso M, Raone B. Radiation-induced cutaneous angiosarcoma of the breast. Am J Med. 2020;33(10):1156-7.⁾	F/70	1	CB + L + RT	14 anos	4	Sem doença	C
Shiraki et al.⁽¹⁶16. Shiraki E, Kang Y, Shibayama T, Tsuyuki S. Two cases of breast angiosarcoma after breast conserving surgery. Surg Case Rep. 2020;6(1):81.⁾	F/72, F/80	2	C + RT/C	18cm/5 anos, 3 anos	32/17	Mortes/ resposta parcial	C/C	Sim/QT
Jayarajah et al.⁽¹⁷17. Jayarajah U, Nagodavithane K, Basnayake O, Seneviratne S. Unusual Presentation of Bilateral Radiation-Induced Angiosarcoma of the Breast. Case Rep Oncol Med. 2020;5768438. doi: 10.1155/2020/5768438. https://doi.org/10.1155/2020/5768438... ⁾	F/62	1	CB + L + RT	0,5cm/5 anos	15	Sem doença	CB + QT
Lewcun et al.⁽¹⁸18. Lewcun JA, Pameijer C, Kass R, Cream L, Hershock D, Brooks AJ, et al. Dodge DG. Doxorubicin, paclitaxel, and cisplatin based chemotherapy for the treatment of angiosarcoma: two case reports. Int J Surg Case Rep. 2020;68:83-7.⁾	F/64	1	CB + QT + RT	0,8cm/6 anos	24	Resposta completa	QT NA + CB
Kong et al.⁽¹⁹19. Kong J, Shahait AD, Kim S, Choi L. Radiation-induced undifferentiated pleomorphic sarcoma of the breast. BMJ Case Rep. 2020;13(2): e232616.⁾	F/75	1	S + L + QT+ RT + H	5,6cm/20 anos	15	Sem doença	C + RT
Suzuki Y et al.⁽²⁰20. Suzuki Y, Taniguchi K, Hatono M, Kajiwara Y, Abe Y, Kawada K, et al. Recurring radiation-induced angiosarcoma of the breast that was treated with paclitaxel chemotherapy: a case report. Surg Case Rep. 2020;6(1):25.⁾	F/62	1	C + RT+ H	8 anos	8	Não recorrência	C + QT	Sim
Amajoud et al.⁽²¹21. Amajoud Z, Vertongen AS, Weytens R, Hauspy J. Radiation induced angiosarcoma of the breast: case series and review of the literature. Facts Views Vis Obgyn. 2018;10(4):215-20.⁾	F/73 ^* * Média.	10	C + RT	10cm/7,3 anos ^* * Média.	13 ^* * Média.	5 mortes e 5 sem a doença	C + QT + RT	Sim
Lee et al.⁽²²22. Lee H, MacDonald SM. Multifocal angiosarcoma secondary to partial breast irradiation: reirradiate? Int J Radiat Oncol Biol Phys. 2019:105(1):17-18.⁾	F/72	1	C + RT	6 anos
Verdura et al.⁽²³23. Verdura V, Di Pace B, Concilio M, Guastafierro A, Fiorillo G, Alfano L, et al. A new case of radiation-induced breast angiosarcoma. Int J Surg Case Rep. 2019;60:152-5.⁾	F/79	1	C + L + QT + RT	2cm/8 anos	12	Sem doença	QT NA + S
Tsapralis et al.⁽²⁴24. Tsapralis N, Vlachogiorgos A, Pham H, Mowatt D. Nothing is impossible: radiation induced angiosarcoma of breast in a male patient. J Surg Case Rep. 2019;2019(5):rjz158.⁾	M/72	1	C + L + RT	6 anos		Morte	C + EQT + QT	Sim
Wei et al.⁽²⁵25. Wei NJ, Crowley TP, Ragbir M. Early breast angiosarcoma development after radiotherapy. Ann Plast Surg. 2019;83(2):152-3.⁾	F/39	1	C + RT	4 anos			C
García Novoa et al.⁽²⁶26. García Novoa A, Acea Nebril B, Bouzón Alejandro A, Cereijo Garea C, Antolín Novoa S. Radiation-induced angiosarcoma of the breast in a Li-Fraumeni patient. Cir Esp. 2019;97(2):114-6.⁾	F/37	1	CB + L + QT + H + RT	0,5cm/4 anos			C
Bonzano et al.⁽²⁷27. Bonzano E, Guenzi M, Corvò R. Salvage hypofractionated radiotherapy in a progressive radiation-induced angiosarcoma: a case report. Cureus. 2017;9(11):e1886.⁾	F/57	1	C + L + RT	10cm/8 anos	30	Sem doença	C + QT + RT
Farran et al.⁽²⁸28. Farran Y, Padilla O, Chambers K, Philipovskiy A, Nahleh Z. Atypical Presentation of Radiation-Associated Breast Angiosarcoma: a case report and review of literature. Am J Case Rep. 2017;18:1347-50.⁾	F/67	1	C + L + RT	1cm/8 anos		Sem doença, em seguimento	C
Disharoon et al.⁽²⁹29. Disharoon M, Kozlowski KF, Kaniowski JM. Case 242: radiation-induced angiosarcoma. Radiology. 2017;283(3):909-16.⁾	F/68	1	C + L + RT	1cm/9 anos			C
Plichta et al.⁽³⁰30. Plichta JK, Hughes K. Radiation-Induced angiosarcoma after breast-cancer treatment. N Engl J Med. 2017;376(4):367.⁾	F/72	1	C + RT	10cm/5 anos	12	Sem doença	C + QT
Tato-Varela et al.⁽³¹31. Tato-Varela S, Albalat-Fernández R, Pabón-Fernández S, Núñez-García D, Calle-Marcos M. Radiation-induced breast angiosarcoma: a case report. Ecancermedicalscience. 2016;10:697.⁾	F/62	1	C + L + RT	1cm/8 anos	0,5	Assintomático	C
Wronski et al.⁽³²32. Wronski K, Frackowiak L. Angiosarcoma following radiation therapy for breast cancer case report. Ann Ital Chir. 2016;5:S2239253X16025032.⁾	F/56	1	C + L + RT	5 anos	0,06	Assintomático	C
Wilhelm et al.⁽³³33. Wilhelm IN, Penman EJ. Radiation associated angiosarcoma: case series from a community cancer center and review of the literature. Del Med J. 2016;88(3):78-82.⁾	F/70 ^* * Média.	7	C + RT	8,5 anos ^* * Média.
Mocerino et al.⁽³⁴34. Mocerino C, Iannaci G, Sapere P, Luise R, Canonico S, Gambardella A. Multidisciplinary approach to breast angiosarcoma in an elderly patient: Repeated local relapses and significant objective responses. Int J Immunopathol Pharmacol. 2016;29(3):537-42.⁾	F/77	1	C + H + RT	2cm		Sem doença	C + EQT + RT + QT	Sim/ RT + QT
Peterson et al.⁽³⁵35. Peterson CB, Beauregard S. Radiation-induced breast angiosarcoma: case report and clinical approach. J Cutan Med Surg. 2016;20(4):304-7.⁾	F/72	1	C + RT	1,5cm/14 anos	20	Sem doença	C
Tidwell et al.⁽³⁶36. Tidwell WJ, Haq J, Kozlowski KF, Googe PB. C-MYC positive angiosarcoma of skin and breast following MammoSite®treatment. Dermatol Online J. 2015;21(10):13030 /qt4t65q9nc.⁾	F/68	1	RT	3cm/9 anos			C	Sim
Uryvaev et al.⁽³⁷37. Uryvaev A, Moskovitz M, Abdach-Bortnyak R, Hershkovitz D, Fried G. Post-irradiation angiosarcoma of the breast: clinical presentation and outcome in a series of six cases. Breast Cancer Res Treat. 2015;153(1):3-8.⁾	F/78 ^* * Média.	6	C + RT	9,2 anos	41,8	4 sem a doença, 1 morte, 1 at QT	C + QT + 3 RT	Sim (3)
Parvez et al.⁽³⁸38. Parvez E, Popovic S, Elavathil L, Okawara G, Hodgson N. Early occurrence of angiosarcoma in a woman with a brca2 gene variation of unknown significance treated with breast-conserving therapy for bilateral ductal carcinoma: a case report. Clin Breast Cancer. 2015;15(6):536-8.⁾	F/55	1	C + L + QT + RT + H	1,5cm/0,5 anos			CB + RT
Styring et al.⁽³⁹39. Styring E, Klasson S, Rydholm A, Vult von Steyern F. Radiation-associated angiosarcoma after breast cancer: Improved survival by excision of all irradiated skin and soft tissue of the thoracic wall? A report of six patients. Acta Oncol. 2015;54(7):1078-80.⁾	F/54,5 ^* * Média.	6	C + RT + 2 QT	7 anos ^* * Média.			C

[1] Autor correspondente: Danilo Rafael da Silva Fontinele, Rua Olavo Bilac, 2.335 CEP: 64045-420 – Teresina, PI, Brasil. Tel.: (86) 3221-4749 E-mail: drsilvafontinele@gmail.com

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Angiossarcoma induzido por radiação: relato de caso

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