Undifferentiated pleomorphic sarcoma with osteoclast-like giant cells of the female breast

Giancarlo Balbi,Luca Di Martino,Francesco Gioia,Diego Pitruzzella,Elisabetta Seguino,Pasquale Orabona,Gianpaolo Pitruzzella,Flavio Grauso,Antonella Napolitano

doi:10.1186/1477-7819-11-21

Abstract

The authors describe a case of undifferentiated pleomorphic sarcoma of the breast occurring in a 50-year-old woman who presented with a palpable mass in her right breast. She first noticed the mass one month previously. Core needle biopsy showed connective tissue including epithelioid and spindle cells. The patient underwent total mastectomy without axillary lymph node dissection. Based on examination of the excised tumor, the initial pathologic diagnosis was atypical spindle-shaped and ovoid cells with uncertain malignant potential. Histological findings with immunomarkers led to the final diagnosis of undifferentiated pleomorphic sarcoma.This case highlights a rare and interesting variant of primary breast sarcoma and the important role of immunohistochemistry in defining histological type and differential diagnosis. Hence, undifferentiated pleomorphic sarcoma has been a diagnosis of exclusion performed through sampling and critical use of ancillary diagnostic techniques.

Highlights

Breast sarcomas are histologically heterogeneous nonepithelial malignancies that arise from the connective tissue within the breast [1]
Primary breast sarcoma is a rare type of cancer arising from the mesenchymal tissue of the breast; it accounts for less than one percent of all breast malignancies [2]
Undifferentiated pleomorphic sarcoma has been rarely seen in the breast [3] and, in the previous reports, it consisted of 10.5 to 24% of all primary breast sarcomas [3,4]

Summary

Background

Breast sarcomas are histologically heterogeneous nonepithelial malignancies that arise from the connective tissue within the breast [1]. Case presentation A 50-year-old woman presented to the Breast Unit of Sant’ Anna and San Sebastiano Hospital of Caserta, Italy, after becoming aware of a non-tender lump in the median areolar area of her right breast. She first noticed the mass one month previously. Macroscopic examination of the specimen, measuring 19 × 15 × 8 cm and including the normal nipple, revealed a grayish, apparently delimited nodular lesion, measuring 10 cm in diameter, with cystic-necrotic and few hemorrhagic areas. Follow-up mammography has been satisfactory to date, and she remained well without tumor recurrence at 15 months

Discussion and conclusion

Findings

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