title: Abrupt tonsillar hemorrhage from a metastatic hemangiosarcoma of the breast: case report and literature review.
abstract: We describe a case of primary breast hemangiosarcoma with tonsillar metastasis that manifested as a profuse oropharyngeal hemorrhage. The patient was a 54-year-old woman who presented to the emergency department with oral bleeding. A thorough examination revealed a distorted morphology of the left tonsil and a hemorrhage originating from it. Conservative methods to control the hemorrhage failed, and tonsillectomy was carried out. Histopathologic analysis revealed that the left tonsil contained hemangiosarcoma cells of the same kind that had been removed from the breast. Primary hemangiosarcomas of the breast are rare; when they do occur, they usually recur locally and spread hematogenously. To the best of our knowledge, this is the first case of a primary breast hemangiosarcoma with tonsillar metastasis to be reported in the literature. We present a detailed analysis of this case, and we review the relevant literature on metastatic tonsillar tumors, with attention to the role of therapeutic embolization.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Rambam Health Care Campus, PO Box 9602, Haifa 31096, Israel. bar1906@netvision.net.il
authors.forename: Ronen
authors.initials: R
authors.lastname: Bar
authors.forename: Aviram
authors.initials: A
authors.lastname: Netzer
authors.forename: Dmitry
authors.initials: D
authors.lastname: Ostrovsky
authors.forename: Marcelo
authors.initials: M
authors.lastname: Daitzchman
authors.forename: Avishay
authors.initials: A
authors.lastname: Golz
mesh_terms: D001943:Breast Neoplasms / Q000473:pathology*; D005260:Female; D006394:Hemangiosarcoma / Q000556:secondary*; D006470:Hemorrhage / Q000209:etiology*; D006801:Humans; D008875:Middle Aged; D014067:Tonsillar Neoplasms / Q000556:secondary*