Focal angiomatosis of the breast with MRI and histologic features

Angiomatosis of the breast is an unusual benign vascular process which may affect middle aged women and simulate carcinoma. We report a unique case of a female patient with cerebellar hemangioblastoma and coexisting breast angiomatosis. We discuss the neuroradiology and breast imaging, illustrating the diagnostic pearls and pitfalls in the setting of this extremely uncommon combination. A 50-year old patient with a history of right-sided cerebellar hemangioblastoma resection 10 years previously presented with a recurrent left sided palpable breast mass. She was referred for triple breast assessment and subsequent ultrasound-guided biopsy. On physical examination, the lesion was hypoechoic, ill-defined and located in the upper outer quadrant as are most breast malignancies. Ultrasound and mammography showed suspicious features. The ipsilateral axilla was normal. Histopathology revealed a diagnosis of breast angiomatosis with no evidence of associated malignancy. Vascular tumors of the breast are very rare, present diagnostic challenges and are prone to local recurrence. Complete excision with clear margins is recommended. Mastectomy is a consideration for diffuse disease that cannot be fully cleared with lumpectomy or Wide local excision. Cerebellar hemangioblastoma and breast angiomatosis is a very unique combination, particularly in the absence of an underlying phacomatosis. Radiological features of angiomatosis mimicking malignancy without pathognomonic imaging signs have been observed. Knowledge of these rare vascular breast tumors is key to making this unusual diagnosis and helps to reduce the number of radical surgical procedures.

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“…[2] Mastectomy is a consideration for diffuse disease that cannot be fully treated with breast-conserving surgery. [1]…”

Section: Discussionmentioning

confidence: 99%

“…Angiomatosis most commonly appears in isolation, may be large, and, due to shared imaging features, needs to be differentiated from angiosarcoma. [1]…”

Section: Introductionmentioning

confidence: 99%

Rare Coexistence of a Cerebellar Hemangioblastoma and Angiomatosis of the Breast without Underlying Phakomatosis

Wegner

Decker

et al. 2019

JCIS

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“…However, the imaging studies cannot totally differentiate between benign and malignant vascular tumour especially angiosarcoma [ 2 ]. Therefore, complete surgical excision is usually required [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

“…Treatment is including complete excision or mastectomy for achieving clear margin. Chemotherapy and radiation in adjuvant treatment have not been described [ 3 ]. Currently, whole breast irradiation is the standard treatment in breast cancer.…”

Section: Discussionmentioning

confidence: 99%

Preoperative radiation in large angiomatosis of the breast, attempting breast conserving surgery: multidisciplinary approach

Chulakadabba

Denariyakoon

Chakkabat

et al. 2018

Journal of Surgical Case Reports

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Angiomatosis of the breast is very rare. The presentations are including breast mass, skin discoloration and breast enlargement that mimic to angiosarcoma. The imaging could suggest non-specific vascular tumors. The histology should be obtained for the certain diagnosis. Surgical excision is the standard treatment. To our knowledge, this is the first case that preoperative radiation is given. Currently, radiation is occasionally used in benign condition. This case shows the successful result of preoperative radiation for achieving breast conserving surgery in large angiomatosis of the breast.

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“…These tumors are often occult to conventional imaging. Especially in the cases of small and asymptomatic VLB mammography (MMG) and ultrasonography (US) are often negative, studies in literature shows that magnetic resonance imaging (MRI) is superior to previous 2 imaging modalities for diagnosis of these small lesions [ 4 , 5 ]. At the MRI angiosarcoma often exhibits iso-ipointensity on T1-weighted images and markedly high signal intensity on T2-weighted images.…”

mentioning

confidence: 99%

Small vascular lesions of the breast diagnosed by magnetic resonance imaging‐guided vacuum assisted biopsy: Report of 2 cases

Perretta¹,

Meucci

Serio³

et al. 2022

Radiology Case Reports

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Focal angiomatosis of the breast with MRI and histologic features

Cited by 6 publications

References 7 publications

Rare Coexistence of a Cerebellar Hemangioblastoma and Angiomatosis of the Breast without Underlying Phakomatosis

Rare Coexistence of a Cerebellar Hemangioblastoma and Angiomatosis of the Breast without Underlying Phakomatosis

Preoperative radiation in large angiomatosis of the breast, attempting breast conserving surgery: multidisciplinary approach

Small vascular lesions of the breast diagnosed by magnetic resonance imaging‐guided vacuum assisted biopsy: Report of 2 cases

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