{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T17:01:07Z","timestamp":1774285267365,"version":"3.50.1"},"reference-count":32,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,2,12]]},"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:p>Primary breast angiosarcoma is an exceptionally rare malignancy, particularly in elderly patients, and may closely resemble benign vascular lesions on imaging and core needle biopsy. We report a case of low-grade primary angiosarcoma in a woman in her late 70s, initially misdiagnosed as a haemangioma despite interval tumour growth. A definitive diagnosis was achieved only after wide local excision, which demonstrated well to intermediately differentiated angiosarcoma with clear margins. Given the limited evidence supporting adjuvant therapy in low-grade disease, surgery alone was appropriate, and the patient remains recurrence-free at 2.5 years. This case highlights the diagnostic challenges and importance of maintaining suspicion in older adults.<\/jats:p>","DOI":"10.1136\/bcr-2025-269640","type":"journal-article","created":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T16:10:14Z","timestamp":1774282214000},"page":"e269640","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Primary low-grade breast angiosarcoma initially misdiagnosed as a benign vascular lesion"],"prefix":"10.1136","volume":"19","author":[{"given":"Fumika","family":"Hanatate","sequence":"first","affiliation":[{"name":"Surgery, Matsunami General Hospital, Hashima District, Gifu Prefecture, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chika","family":"Yumura","sequence":"additional","affiliation":[{"name":"Surgery, Matsunami General Hospital, Hashima District, Gifu Prefecture, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maiko","family":"Sugimoto","sequence":"additional","affiliation":[{"name":"Surgery, Matsunami General Hospital, Hashima District, Gifu Prefecture, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keisuke","family":"Kawashima","sequence":"additional","affiliation":[{"name":"Pathology, Matsunami General Hospital, Hashima District, Gifu Prefecture, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,3,23]]},"reference":[{"key":"2026032309100745000_19.3.e269640.1","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1186\/s43055-021-00494-1","article-title":"Imaging spectrum of angiosarcoma of the breast","volume":"52","author":"Pang","year":"2021","journal-title":"Egypt J Radiol Nucl Med"},{"key":"2026032309100745000_19.3.e269640.2","unstructured":"Tavassoli FA . Pathology of the breast. 2nd edn. Stamford: Appleton & Lange, 1999."},{"key":"2026032309100745000_19.3.e269640.3","first-page":"144","article-title":"Primary breast angiosarcoma","volume":"5","author":"Pandey","year":"2014","journal-title":"World J Oncol"},{"key":"2026032309100745000_19.3.e269640.4","first-page":"261","article-title":"Primary angiosarcoma of the breast: a case report and review of the literature","volume":"42","author":"Frey","year":"2015","journal-title":"Arch Plast Surg"},{"key":"2026032309100745000_19.3.e269640.5","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1023\/A:1006277617884","article-title":"Color Doppler ultrasound in benign and malignant breast tumors","volume":"57","author":"Chao","year":"1999","journal-title":"Breast Cancer Res Treat"},{"key":"2026032309100745000_19.3.e269640.6","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1007\/s13193-017-0626-5","article-title":"Patient Complaints in Benign vs. Malignant Breast Disease","volume":"8","author":"Karimian","year":"2017","journal-title":"Indian J Surg Oncol"},{"key":"2026032309100745000_19.3.e269640.7","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1186\/1746-1596-8-66","article-title":"Angiosarcoma of the breast: a clinicopathologic study of 11 cases","volume":"8","author":"Bennani","year":"2013","journal-title":"Diagn Pathol"},{"key":"2026032309100745000_19.3.e269640.8","doi-asserted-by":"crossref","first-page":"120","DOI":"10.4103\/0973-1482.63543","article-title":"Primary angiosarcoma of breast: a rare case report","volume":"6","author":"Rohan","year":"2010","journal-title":"J Cancer Res Ther"},{"key":"2026032309100745000_19.3.e269640.9","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1016\/j.ijscr.2013.01.016","article-title":"Primary angiosarcoma of breast: a rare malignancy","volume":"4","author":"Bhosale","year":"2013","journal-title":"Int J Surg Case"},{"key":"2026032309100745000_19.3.e269640.10","doi-asserted-by":"crossref","first-page":"15","DOI":"10.3941\/jrcr.v13i2.3449","article-title":"MRI of primary breast angiosarcoma","volume":"13","author":"Varghese","year":"2019","journal-title":"J Radiol Case Rep"},{"key":"2026032309100745000_19.3.e269640.11","unstructured":"Rivas-Mendoza UN , Gonzales A , Garza LA . Radiation-associated angiosarcoma of the breast: treatment and outcome. Radiother Clin Oncol 2021."},{"key":"2026032309100745000_19.3.e269640.12","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1093\/jbi\/wbae011","article-title":"Breast Hemangiomas: Imaging Features With Histopathology Correlation","volume":"6","author":"Dhami","year":"2024","journal-title":"J Breast Imaging"},{"key":"2026032309100745000_19.3.e269640.13","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1067\/j.cpradiol.2023.01.002","article-title":"Comparing Breast Hemangiomas to Breast Angiosarcomas: An Imaging Based Review","volume":"52","author":"Shin","year":"2023","journal-title":"Curr Probl Diagn Radiol"},{"key":"2026032309100745000_19.3.e269640.14","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1097\/00000478-198110000-00005","article-title":"Angiosarcoma and other vascular tumors of the breast","volume":"5","author":"Donnell","year":"1981","journal-title":"Am J Surg Pathol"},{"key":"2026032309100745000_19.3.e269640.15","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e318176dbc7"},{"key":"2026032309100745000_19.3.e269640.16","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1111\/tbj.13247","article-title":"Case of low\u2010grade primary angiosarcoma of the breast with early recurrence","volume":"25","author":"Hu","year":"2019","journal-title":"Breast J"},{"key":"2026032309100745000_19.3.e269640.17","doi-asserted-by":"crossref","first-page":"369","DOI":"10.2325\/jbcs.13.369","article-title":"Angiosarcoma of the Breast \u2013 specific findings of MRI","volume":"13","author":"Kikawa","year":"2006","journal-title":"Breast Cancer (Auckl)"},{"key":"2026032309100745000_19.3.e269640.18","doi-asserted-by":"crossref","DOI":"10.1186\/s12885-017-3292-7","article-title":"Radiation-associated vs primary angiosarcoma of the breast: a retrospective population-based study","volume":"17","author":"Yin","year":"2017","journal-title":"BMC Cancer"},{"key":"2026032309100745000_19.3.e269640.19","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1007\/s10549-019-05172-5","article-title":"Outcomes of angiosarcoma of the breast: a SEER database analysis","volume":"175","author":"McClelland","year":"2019","journal-title":"Breast Cancer Res Treat"},{"key":"2026032309100745000_19.3.e269640.20","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1007\/s00595-010-4341-x","article-title":"Breast angiosarcoma that is not related to radiation exposure: a comprehensive review of the literature","volume":"41","author":"Kaklamanos","year":"2011","journal-title":"Surg Today"},{"key":"2026032309100745000_19.3.e269640.21","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1007\/s10549-019-05432-4","article-title":"Primary and secondary breast angiosarcoma: single center report and a meta-analysis","volume":"178","author":"Abdou","year":"2019","journal-title":"Breast Cancer Res Treat"},{"key":"2026032309100745000_19.3.e269640.22","doi-asserted-by":"publisher","DOI":"10.3109\/07357909409024870"},{"key":"2026032309100745000_19.3.e269640.23","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19881115)62:10<2145::AID-CNCR2820621014>3.0.CO;2-O"},{"key":"2026032309100745000_19.3.e269640.24","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(03)00269-1"},{"key":"2026032309100745000_19.3.e269640.25","doi-asserted-by":"crossref","first-page":"3272","DOI":"10.3390\/curroncol29050267","article-title":"Primary Angiosarcoma of the Breast: A Single-Center Retrospective Study in Korea","volume":"29","author":"Kim","year":"2022","journal-title":"Curr Oncol"},{"key":"2026032309100745000_19.3.e269640.26","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijscr.2023.108163","article-title":"Primary angiosarcoma of breast in an octogenarian woman: A case report with literature review","volume":"107","author":"Vohra","year":"2023","journal-title":"Int J Surg Case Rep"},{"key":"2026032309100745000_19.3.e269640.27","doi-asserted-by":"crossref","first-page":"108700","DOI":"10.1016\/j.ijscr.2023.108700","article-title":"Primary breast angiosarcoma in a postmenopausal woman: A case report","volume":"110","author":"Killoran","year":"2023","journal-title":"Int J Surg Case Rep"},{"key":"2026032309100745000_19.3.e269640.28","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1055\/s-0042-1754358","article-title":"Primary Angiosarcoma of the Breast: A Rare Case Report in Postmenopausal Women","volume":"32","author":"Issar","year":"2022","journal-title":"Indian J Radiol Imaging"},{"key":"2026032309100745000_19.3.e269640.29","doi-asserted-by":"crossref","first-page":"437","DOI":"10.12659\/AJCR.913068","article-title":"Primary Epithelioid Angiosarcoma of the Breast: A Rare and Challenging Biopsy Diagnosis","volume":"20","author":"Mendoza","year":"2019","journal-title":"Am J Case Rep"},{"key":"2026032309100745000_19.3.e269640.30","doi-asserted-by":"publisher","DOI":"10.1016\/S0007-1226(03)00025-0"},{"key":"2026032309100745000_19.3.e269640.31","doi-asserted-by":"crossref","first-page":"28","DOI":"10.21037\/jrh.2016.11.02","article-title":"Primary angiosarcoma of the breast in a seventy-year-old female: a rare case report","volume":"1","author":"Athar","year":"2016","journal-title":"J Res Hosp"},{"key":"2026032309100745000_19.3.e269640.32","doi-asserted-by":"crossref","first-page":"21504","DOI":"10.1200\/jco.2008.26.15_suppl.21504","article-title":"Angiosarcoma of the breast: A rare clinicopathological entity","volume":"26","author":"Biswas","year":"2008","journal-title":"JCO"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-269640","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T16:10:18Z","timestamp":1774282218000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-269640"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":32,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,3,23]]},"published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1136\/bcr-2025-269640"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-269640","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3]]}}}