Radiotherapy-associated angiosarcoma in the breast reconstructed by autologous free-flap and treated with electrochemotherapy: case report and literature review

  • Romi Cencelj-Arnez Department of Surgical Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia
  • Jerica Novak Department of Surgical Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia
  • Andreja Klevisar Ivancic Department of Pathology, Institute of Oncology Ljubljana, Slovenia
  • Maša Bošnjak Institute of Oncology Ljubljnana
  • Maja Cemazar Department of Experimental Oncology, Institute of Oncology, Ljubljana, Slovenia
  • Marko Snoj Department of Surgical Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia

Abstract

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.

Conclusion. 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.

Published
2021-02-15
How to Cite
Cencelj-Arnez, R., Novak, J., Klevisar Ivancic, A., Bošnjak, M., Cemazar, M., & Snoj, M. (2021). Radiotherapy-associated angiosarcoma in the breast reconstructed by autologous free-flap and treated with electrochemotherapy: case report and literature review. Radiology and Oncology, 55(1), 77-81. Retrieved from https://radioloncol.com/index.php/ro/article/view/3593
Section
Clinical oncology