Angiosarcoma of the Breast with Solitary Metastasis to the Ovary during Pregnancy: An Uncommon Pattern of Metastatic Disease
(a) Gross photograph of a transverse section of the large 14 × 10 × 6 cm ovarian mass. This lesion is seen to essentially replace the entire ovary and is composed of fleshy, deep red tissue. The ovarian surface is smooth and the capsule is grossly intact. There are areas of pallor and an area of necrosis at the left. (b) Histology from the previous mastectomy specimen shows extensive angiosarcoma within the deep breast parenchyma comprising irregularly anastomosing vascular channels lined by spindle cells with hyperchromatic nuclei. There is some preservation of breast lobular units (bottom right of field). (c) The subsequent oophorectomy specimen shows almost complete effacement of the ovarian parenchyma by similar angiosarcoma. Note the completely intact capsule and absence of tumor on the ovarian surface. (d) Only tiny amounts of peripheral ovarian parenchyma remain: a thin rim of ovarian tissue is seen peripherally and an intact follicle is seen on the left. The tumor is well differentiated and extensively vasoformative, with formation of blood lakes. (e) At higher power, the vascular channels are lined by mildly to moderately atypical spindle cells. (f) The cells are diffusely positive for CD34.