A 65-year-old woman with a history of breast conservation surgery and radiotherapy for breast cancer 10 years ago presents with multiple violaceous skin nodules on the irradiated chest wall. Biopsy shows atypical vascular cells. What is the most likely diagnosis?

• A Radiation-induced fibrosis
• B Cutaneous angiosarcoma (Stewart-Treves syndrome) ✓
• C Local recurrence of breast carcinoma
• D Kaposi sarcoma

Explanation

Cutaneous angiosarcoma of the chest wall is a rare but well-documented complication of radiotherapy for breast cancer, known as radiation-induced angiosarcoma. It presents as violaceous skin nodules and is distinct from Stewart-Treves syndrome, which occurs in the lymphedematous upper limb post-mastectomy.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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