A Case Report of Solitary Bone Metastasis from Primary Angiosarcoma of the Bilateral Breasts – A Rare Diagnosis

Case Report | Volume 7 | Issue 1 | JBST January – April 2021 | Page 12-17 | Katrina Ysabel R Naraval, Daniela Kristina D. Carolino, Ma. Lilia Molina P. Jose. DOI: 10.13107/jbst.2021.v07i01.43

Author: Katrina Ysabel R Naraval[1], Daniela Kristina D. Carolino[1], Ma. Lilia Molina P. Jose[1], [2]

[1]Institute of Orthopaedics and Sports Medicine, St. Luke’s Medical Center, 279 E. Rodriguez Sr. Blvd., Quezon city 1112, Philippines,
[2]Orthopaedic Oncology section, Department of Orthopaedics, The Medical City Clark, Pampanga, Philippines.

Address of Correspondence
Dr. Katrina Ysabel R Naraval,
Institute of Orthopaedics and Sports Medicine, St. Luke’s Medical Center, 279 E. Rodriguez Sr. Blvd., Quezon city 1112, Philippines.
E-mail: khayanaraval@gmail.com


Abstract

Introduction: Primary angiosarcoma of the breast is an uncommon subtype of soft-tissue sarcoma known to be aggressive and is associated with distant metastasis and poor prognosis. Solitary bone metastases occurring in these cases are even more rare with the available limited literature based from small retrospective case series.
Case Report: We present a case of a 24-year-old Filipino female previously diagnosed with primary angiosarcoma of the bilateral breasts, initially presenting with a 3-month history of the right hip pain and consulted due to a pathologic fracture of the right proximal femur. Diagnostic tests done confirmed solitary skeletal metastasis to this area, for which she underwent wide resection and application of a proximal femoral endoprosthesis. Postoperatively, the patient was able to independently ambulate, with follow-up radiographs showing stable implant fixation. Further imaging showed that lesion-free bones, however, noted development of distant recurrence manifesting with pulmonary metastases and hemorrhagic subcutaneous lesions 3 months after. Adequate tumor resection and radiotherapy are reported to successfully treat isolated skeletal metastasis in the proximal femur. The presence of the pathologic fracture before definitive treatment may have contributed to its distant recurrence, in addition to an already aggressive nature of the primary malignancy.
Conclusion: In the background of primary breast angiosarcoma, although rare, high suspicion for isolated skeletal metastasis in a symptomatic patient prevents delay in definitive management, which avoids progression to a poorer prognosis.
Keywords: Solitary bone metastasis, angiosarcoma, proximal femur, pathologic fracture.


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How to Cite this article: Naraval KYR, Carolino DKD, Jose MLMP | A Case Report of Solitary Bone Metastasis from Primary Angiosarcoma of the Bilateral Breasts – A Rare Diagnosis | Journal of Bone and Soft Tissue Tumors | Jan-Apr 2021; 7(1): 12-17.

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