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Chandra Doval D, Tayal J, Dutta Choudhary K, Goyal P, Gupta G, Pasricha S. Treatment conundrums in osteosarcoma of the breast: Case report of two cases from a tertiary care cancer center in India. Turk J Surg 2022; 38:409-412. [PMID: 36875268 PMCID: PMC9979553 DOI: 10.47717/turkjsurg.2022.4075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Accepted: 09/26/2022] [Indexed: 01/11/2023]
Abstract
Extraosseous sarcoma of the breast is an infrequent entity and a harbinger of poor prognosis. Histogenesis of this tumor is uncertain, and it can arise both in denovo and metastatic settings. Morphologically, it is indistinguishable from its skeletal counterpart and clinically, it presents like any other subtype of breast cancer. Tumor recurrence with a propensity for hematogenous rather than lymphatic spread plagues with this malicious disease. Treatment guidelines are mainly extrapolations from those of treatment of other extra-skeletal sarcomas as literature is limited in this context. In this study, it was aimed to present two clinical cases with similar clinical profiles and different treatment outcomes. The intent of this case report is to contribute to the limited database available for management of this rare disease.
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Affiliation(s)
- Dinesh Chandra Doval
- Department of Medical Oncology, Centre of Rajiv Gandhi Cancer Institute & Research, Delhi, India
| | - Juhi Tayal
- Department of Research, Centre of Rajiv Gandhi Cancer Institute & Research Delhi, India
| | | | - Pankaj Goyal
- Department of Medical Oncology, Centre of Rajiv Gandhi Cancer Institute & Research, Delhi, India
| | - Gurudutt Gupta
- Department of Laboratory Services, Centre of Rajiv Gandhi Cancer Institute & Research, Delhi, India
| | - Sunil Pasricha
- Department of Laboratory Services, Centre of Rajiv Gandhi Cancer Institute & Research, Delhi, India
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Wu NF, Wu J, Yamamoto J, Aoki Y, Hozumi C, Bouvet M, Hoffman RM. The First Mouse Model of Primary Osteosarcoma of the Breast. In Vivo 2021; 35:1979-1983. [PMID: 34182472 DOI: 10.21873/invivo.12466] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 05/13/2021] [Accepted: 05/27/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Sarcomas of the breast are extremely rare malignant tumors and comprise only 5% of all sarcomas and fewer than 1% of breast cancers. Primary osteosarcoma of the breast is histologically indistinguishable from osteosarcoma of the bone. Effective therapies of this recalcitrant disease have not yet been developed. MATERIALS AND METHODS A patient-derived xenograft (PDX) mouse model of primary osteosarcoma of the breast was established by subcutaneous implantation of the surgical specimen, along with surrounding normal tissue. Hematoxylin and eosin (H&E) staining was performed on paraffin-embedded histological sections of the original tumor resected from the patient and from implanted tumors that grew in nude mice. RESULTS Tumors grew in 46 of 51 mice implanted with the original surgical specimen. The H&E-stained slides of the mouse-grown tumor and the original patient tumor matched, both showing large areas of spindle-shaped cells, characteristic of osteosarcoma. CONCLUSION The first PDX mouse model of primary breast osteosarcoma was established which will enable testing of novel therapeutics as well as basic research of osteosarcoma of the breast.
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Affiliation(s)
- Nathaniel F Wu
- AntiCancer Inc, San Diego, CA, U.S.A.,Department of Molecular and Cellular Biology, Harvard University, Cambridge, MA, U.S.A
| | - Justin Wu
- Department of General Surgery, Kaiser Permanente San Diego Medical Center, San Diego, CA, U.S.A.,Department of Surgery, University of California, San Diego, CA, U.S.A
| | - Jun Yamamoto
- AntiCancer Inc, San Diego, CA, U.S.A.,Department of Surgery, University of California, San Diego, CA, U.S.A
| | - Yusuke Aoki
- AntiCancer Inc, San Diego, CA, U.S.A.,Department of Surgery, University of California, San Diego, CA, U.S.A
| | | | - Michael Bouvet
- Department of Surgery, University of California, San Diego, CA, U.S.A
| | - Robert M Hoffman
- AntiCancer Inc, San Diego, CA, U.S.A.; .,Department of Surgery, University of California, San Diego, CA, U.S.A
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Bartlett H, Elghobashy M, Deshmukh N, Rao R, Shaaban AM. Radiation-Associated Primary Osteosarcoma of the Breast. Pathobiology 2020; 87:322-326. [PMID: 32920553 DOI: 10.1159/000509580] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 06/22/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Non-epithelial primary mammary osteosarcomas are extremely rare. The differentials include metaplastic carcinoma and malignant phyllodes tumour. This is the first published case of primary breast osteosarcoma arising after local radiotherapy. CASE PRESENTATION A 73-year-old female presented with a right-sided breast lump. The same breast had been irradiated 11 years previously for invasive ductal carcinoma. Diagnostic excision revealed a highly cellular, malignant spindle-cell lesion merged with an osteoid matrix and foci of calcification and bone formation. Immunohistochemistry and molecular studies showed no lines of differentiation. Due to the lack of epithelial/glandular differentiation, in situ carcinoma or leaf-like pattern, the diagnosis of post-irradiation osteosarcoma was made. She underwent mastectomy and is disease-free at 8 months of follow-up. CONCLUSION Post-irradiation osteosarcoma should be considered in the differential diagnosis of breast lesions showing malignant osteoid. Extensive sampling and careful search for epithelial differentiation is required to guide management. Complete surgical excision is recommended.
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Affiliation(s)
- Helen Bartlett
- Department of Histopathology, Hereford County Hospital, Hereford, United Kingdom,
| | | | - Nayneeta Deshmukh
- Department of Cellular Pathology, Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom
| | - Rashmi Rao
- Department of Histopathology, Hereford County Hospital, Hereford, United Kingdom
| | - Abeer M Shaaban
- Department of Cellular Pathology, Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom
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Shin GW, Park HY, Park YM. Mucinous Breast Carcinoma Presenting as a Coarse and Densely Calcified Mass on Mammography: A Case Report. TAEHAN YONGSANG UIHAKHOE CHI 2020; 81:1266-1271. [PMID: 36238037 PMCID: PMC9431855 DOI: 10.3348/jksr.2019.0083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 11/14/2019] [Accepted: 12/16/2019] [Indexed: 06/16/2023]
Abstract
We report herein a 46-year-old woman who presented with mucinous breast carcinoma that appeared as a coarse and densely calcified mass on mammography. The lesion was a 4.6-cmsized palpable, hyperechoic, calcified mass with posterior shadowing on ultrasonography. This finding is a unique feature of mucinous breast carcinoma and is also observed in unusual breast cancer variants such as metaplastic breast cancer with chondroid differentiation, extraosseous osteosarcoma, and breast chondrosarcoma. The lesion showed a slow-growing pattern throughout the 4-year observation period. Mammography performed 4 years ago revealed faint, grouped microcalcifications; the lesion increased in size over 2 years, presenting as a well-circumscribed, calcified mass, mimicking dystrophic calcification. As several unusual variants of breast cancer, including mucinous carcinoma, may present as coarse and densely calcified masses on mammography, immediate biopsy should be considered when they are observed.
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Clinical significance of phenotyping and karyotyping of detecting circulating tumor cells in renal cell carcinoma using subtraction enrichment and immunostaining-fluorescence in situ hybridization (SE-iFISH). Int Urol Nephrol 2020; 52:2281-2287. [PMID: 32748196 DOI: 10.1007/s11255-020-02587-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 07/26/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND OBJECTIVES Circulating tumor cells (CTCs) as a noninvasive detection technology have become a research hotspot in the field of precision medicine. However, CTC detection faces great challenges with respect to specificity and sensitivity. METHODS We divided 39 subjects into three groups: renal carcinoma, renal stones and healthy persons. Using subtraction enrichment (SE) combined with immunostaining-fluorescence in situ hybridization technology, we identified and characterized CTCs. CTCs were identified as DAPI +/CD45-/PanCK + (-). We explored whether the number of CTCs was related to clinicopathological factors and their clinical application. RESULTS The CTC count in the renal carcinoma group (29/39) was 86.20% using a cut-off value of 1 CTC, which was significantly higher than that of other technologies in detecting CTCs, demonstrating that SE-iFISH technology can be used for CTC detection. The CTC count was much higher in the renal carcinoma group than that in the other control groups, with an area under the ROC curve of 0.931 (95% confidence interval 0.851 to 1.000, P < 0.01). In addition, the tetraploid count on chromosome 8 of T4 stage renal carcinoma was much higher than that of other stages (T1-T3), which may suggest that tetraploid count could be a marker of renal carcinoma prognosis and influence treatment decisions for better clinical management. CONCLUSIONS Our study showed that SE-iFISH technology can be used to detect CTCs in renal carcinoma with high sensitivity and specificity. Therefore, the analysis of CTCs with SE-iFISH has clear potential to improve the management of patients with renal carcinoma.
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Pasta V, Monti M, Cialini M, Vergine M, Urciuoli P, Iacovelli A, Rea S, D'Orazi V. Primitive sarcoma of the breast: new insight on the proper surgical management. J Exp Clin Cancer Res 2015; 34:72. [PMID: 26219853 PMCID: PMC4518869 DOI: 10.1186/s13046-015-0190-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 07/10/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Primitive sarcoma of the breast is a rare and challenging disease at high risk of recurrence and with poor prognosis. There are controversies in the diagnosis and management of such solid tumor due to its rarity and heterogeneity. This sarcoma is poorly responsive to both chemotherapy and radiotherapy, thus, surgery is the first and most important therapeutic approach. However, given the rarity of this type tumor it has not be possible to standardize unique guidelines for the proper surgical strategy to adopt. Here, we performed a retrospective study of new 10 cases of primitive sarcoma of the breast that underwent either mastectomy or a more conservative quadrantectomy, in the attempt to better standardize correct surgical indications. METHODS Ten new cases of primitive sarcoma of the breast were registered between 2002 and 2012 and constituted the study group. They underwent either mastectomy or quadrantectomy and the clinical, prognostic and survival characteristics after surgery were analysed. RESULTS Within the group of patients treated with mastectomy, two had metastasis and died because of that. Among the five patients treated with quadrantectomy four are alive and free of disease after 3 to 5 years follow-up, while the patient with sarcoma arising in pregnancy, although is still alive, developed lung metastases four years after surgery. CONCLUSIONS The first and most important therapeutic approach to primary sarcomas of the breast is surgical which has the purpose to achieve radical tumor excision to prevent local recurrence and skip metastases. However, given the rarity of the condition and the consequent small number of cases in this, like in similar studies, it is not possible to draw any definitive conclusions and further studies with larger numbers are necessary. However it would appear that performing a larger procedure such as mastectomy rather than performing a more limited one such as a quadrantectomy, has no advantage in terms of overall prognosis.
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Affiliation(s)
- Vittorio Pasta
- Department of Surgical Sciences, "Sapienza" University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.
| | - Massimo Monti
- Department of Surgical Sciences, "Sapienza" University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.
| | - Michela Cialini
- Department of General Microsurgery and Hand Surgery, "Fabia Mater" Hospital, Via Olevano Romano 25, 00171, Rome, Italy.
| | - Massimo Vergine
- Department of Surgical Sciences, "Sapienza" University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.
| | - Paolo Urciuoli
- Department of Surgical Sciences, "Sapienza" University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.
| | - Annunziata Iacovelli
- Department of Gynecology, "Fabia Mater" Hospital, Via Olevano Romano 25, 00171, Rome, Italy.
| | - Silvio Rea
- Department of Surgical Oncology, University of L'Aquila, Via Vetoio località Coppito, 67100, L'Aquila, Italy.
| | - Valerio D'Orazi
- Department of Surgical Sciences, "Sapienza" University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.
- Department of General Microsurgery and Hand Surgery, "Fabia Mater" Hospital, Via Olevano Romano 25, 00171, Rome, Italy.
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Dolka I, Sapierzyński R, Król M. Retrospective study and immunohistochemical analysis of canine mammary sarcomas. BMC Vet Res 2013; 9:248. [PMID: 24321325 PMCID: PMC4029385 DOI: 10.1186/1746-6148-9-248] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2013] [Accepted: 12/02/2013] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Canine mammary sarcomas (CMSs) are rarely diagnosed in female dogs, which explains the scarcity of immunohistochemical findings concerning those tumors. This paper presents the results of a retrospective study into CMSs and discusses the clinical features of the analyzed tumors, the expression of intermediate filaments CK, Vim, Des and α-SMA, and the expression of p63, Ki67, ERα, PR and p53 protein. RESULTS Four percent of all canine mammary tumors (CMTs) were classified as CMSs, and they represented 5.1% of malignant CMTs. The mean age at diagnosis was 11.1 ± 2.8 years. Large breed dogs were more frequently affected (38.7%). The majority of observed CMSs were fibrosarcomas (2.1%). All CMSs expressed vimentin, and higher levels of vimentin expression were noted in fibrosarcomas and osteosarcomas. Ki67 expression was significantly correlated with the grade of CMS. CONCLUSIONS Our results revealed that CMSs form a heterogeneous group, therefore, immunohistochemical examinations could support differential and final diagnosis. Although this study analyzed a limited number of samples, the reported results can expand our knowledge about CMSs. Further work is required in this field.
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Affiliation(s)
- Izabella Dolka
- Department of Pathology and Veterinary Diagnostics, Faculty of Veterinary Medicine, Warsaw University of Life Sciences-WULS, Nowoursynowska 159c, Warsaw 02-776, Poland
| | - Rafał Sapierzyński
- Department of Pathology and Veterinary Diagnostics, Faculty of Veterinary Medicine, Warsaw University of Life Sciences-WULS, Nowoursynowska 159c, Warsaw 02-776, Poland
| | - Magdalena Król
- Department of Physiological Sciences, Faculty of Veterinary Medicine, Warsaw University of Life Sciences-WULS, Nowoursynowska 159c, Warsaw 02-776, Poland
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