case_images: PMC9338697_01
case_images: A) ultrasound image of the right breast: nodule with heterogenous echostructure (yellow asterisk); B) gross examination of the two adjacent tumors: spongy and hemorrhagic well-defined tumor (yellow arrow) adjacent to a second grayish-white and irregular tumor (black arrow); C) angiosarcomatous proliferation: anastomosing and irregular vessels with intraluminal tufting (HEx200); D) area of invasive carcinoma of no special type: cords and glandular structures composed of atypical cells (HEx200)
case_images: PAMJ-42-70-g001.jpg
case_images: PMC9338697_01_PAMJ-42-70-g001.jpg
case_images: F1
case_images: Diagnostic assessment: ultrasound examination disclosed a nodule with heterogeneous echostructure measuring 9.2 cm (Figure 1A). At gross examination, there was a spongy and hemorrhagic tumor measuring 8.5 cm, in contact with a second grayish-white tumor measuring 3 cm (Figure 1B). Microscopically, the spongy tumor showed findings consistent with high grade (HG) PBAS (Figure 1C). Tumor cells were cuboidal with hyperchromatic and voluminous nuclei (Figure 1D).
case_images: histological feature of the two adjacent tumors: angiosarcomatous proliferation (yellow asterisk) in contact with an invasive carcinoma (black asterisk) without histological admixture: A) low magnification (HEx100); B) high magnification (HEx200); C) CD31 immunohistochemical study: vascular proliferation positive for CD31 (x400); D) progesterone receptor immunohistochemical study: carcinomatous proliferation positive for progesterone receptor (black asterisk); vascular proliferation negative for progesterone receptor (yellow asterisk) (x100)
case_images: PAMJ-42-70-g002.jpg
case_images: PMC9338697_01_PAMJ-42-70-g002.jpg
case_images: F2
case_images: No images of intermingled epithelial and vascular proliferations were seen (Figure 2 (A,B)). Ki-67 was 10% (Figure 2 (C,D)).