Primary osteogenic sarcoma of the breast

Primary breast osteosarcoma in a patient previously treated for ipsilateral invasive ductal carcinoma: An unusual case report with clinical and genomic features

Primary breast osteosarcoma is a rare subtype of breast malignancy with limited clinical evidence, inadequate biological understanding, and unmet treatment consensus. Here, we report an unusual case of primary breast osteosarcoma developing in the same quadrant of the breast 2 years after initial dissection and radiation of invasive ductal carcinoma. Thorough evaluations of imaging and pathology were conducted while genomic alterations of both primary and secondary tumors, as well as peripheral blood samples, were explored through the next-generation sequencing technique. A comprehensive review of the current literature was also performed on this rare malignancy.

Extraskeletal Osteosarcoma: A Case Report

Extraskeletal osteosarcoma (ESO) is a rare form of osteosarcoma that has no attachment to bone and can be found in the thigh, retroperitoneum, chest, breast, orbit, retropharyngeal space etc. Literature about ESO is still mainly case reports and case series with few reported cases in our environment. We therefore report this 52-year-old with swelling at the left shoulder which progressed over a 3-year period. Pre-operative evaluation (both clinical, radiological and histopathological) were in favor of soft tissue sarcoma. A wide local excision showed no bony attachment intra-operatively. Histology of the specimen confirmed ESO. Patient had adjuvant chemotherapy and was followed up for 14 months before this report with no sign of local recurrence or distant metastases.

Primary Osteosarcoma of the Breast: Pathophysiology and Imaging Review

Extraskeletal osteosarcoma are rare malignant mesenchymal neoplasms of soft tissues representing around 1% of all soft tissue. The exact mechanism of tumorigenesis of primary breast osteosarcoma is still unclear. However, most of the cases develop without a recognized etiologic factor. Primary osteosarcoma of the breast is often initially misdiagnosed as breast fibroadenoma. Different imaging modalities and pathology play important role in differentiating breast osteosarcoma from other benign and malignant lesions of the breast resulting in dramatic change in the management.

Primary Osteosarcoma of the Breast

Extraskeletal osteosarcomas are extremely rare and account for < 1% of the soft tissue sarcomas. Most common site is in soft tissues of the lower extremities. Primary osteosarcomas of the breast are extremely rare and only a few cases have been reported in literature. It carries a very dismal prognosis in view of its high rate of local recurrence and distant spread. We report a case of primary osteosarcoma of the breast. A 44-year-old female presented with a 14 × 10 cm solid mass in right breast. She underwent wide excision and frozen section was consistent with metaplastic carcinoma. A possibility of malignant phyllodes tumor was kept therefore right axillary dissection was also done along with. Final histopathology was consistent with high-grade osteogenic sarcoma in view of haphazardly arranged spindle to stellate cells with presence of giant cells and a matrix showing osteoid and cartilaginous differentiation and on IHC tumor cells were positive for Vimentin, EMA, Pankeratin, and P 63 and negative for ER, PR, Her 2 neu, CK 7, CK 8/18, and CK 34. It is imperative to recognize this rare pathologic tumor variant in view of its need of multimodal management and overall poor prognosis. Immunohistochemistry plays an important part in establishing the diagnosis and hence the further management.

Chondroblastic osteosarcoma of breast in a case of phyllodes tumour with recurrence, a rare case report

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Chondroblastic ostsarcomas of breast is extremely rare.

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Histology report of biopsy showed a malignant phyllodes with chondrosarcomatous differentiation.

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Mastectomy was followed by Adjuvant chemotherapy.

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There was recurrence after 6 months of surgery.

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Recurrence was managed by radical mastectomy with LD flap.

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Now there is extensive metastasis.

Introduction

Primary extra osseous osteogenic sarcomas have been reported in many tissues of the body but their occurrence in the breast is extremely rare. It can arise as a result of osseous metaplasia in a pre-existing benign or malignant neoplasm of the breast.

Case presentation

A 24 year-old young lady was diagnosed to have mass in right breast.Tru cut biopsy showed it was malignant phyllodes tumour. There was no distant metastasis or any axillary lymph nodes palpable. Simple mastectomy was done. The histology report of biopsy showed a malignant phyllodes with chondrosarcomatous differentiation an myxoid changes. She was given 6 cycles of chemotherapy.

There was recurrence after 6 months of surgery. Then radical mastectomy with latissimus dorsi musculocutaneous flap was used to cover the anterior chest wall defect. Sections from the mastectomy specimen confirmed the diagnosis of chondroblastic osteosarcoma. Axillary nodes free of tumour cells.

Now the patient again came with recurrence after 5 months, and disseminate subcutaneous nodules.

Conclusion

A diagnosis of chondroblastic osteosarcoma of the breast was made based on histology report and after excluding any osteogenic sarcoma arising from underlying ribs and sternum. It is a very rare disease with only few case reports in literature.

Primary osteosarcoma of the breast after complete resection of a metaplastic ossification: a case report

BACKGROUND

Primary osteosarcoma of the breast is an extremely rare lesion. The pathogenesis of primary osteosarcomas is controversial.

CASE PRESENTATION

We present the case of a 63-year-old white German woman who presented with a mass in her right breast after routine screening. The core needle biopsy showed ductal hyperplasia with metaplastic ossification of the breast tissue. Complete excision of the lesion with standard safety margins was performed. The final diagnosis was metaplastic ossification. Three years later, our patient presented again with a painless lump in her right breast about 15 × 8 × 7 cm, extending to the lower part of axilla with skin ulceration. Pathologic diagnosis was osteosarcoma. Positron emission tomography and computed tomography and staging showed no other lesions. Modified radical mastectomy and axillary lymph node dissection was performed, no lymph node metastases were found.

CONCLUSIONS

Our case highlights the possibility that primary osteosarcoma of the breast may develop after complete resection with the classical safety margin for metaplastic ossification. Long-term follow-up after resection of this benign breast lesion is required.

Primary osteosarcoma of the breast: A case report

Osteosarcoma (OS) located in the breast is an extremely rare, malignant neoplasm. The current study presents the diagnostic process, treatment and follow-up of a 67-year-old female with OS of the breast. The diagnosis was made according to diagnostic imaging methods and microscopic examination with additional immunohistochemical staining. As a surgical treatment, tumourectomy with intraoperative histological examination and simple breast amputation was performed. No adjuvant chemotherapy was administered following surgery. Lung and bone metastases occurred without local recurrence 14 months following the surgery. In the present study, the details of the diagnostic examinations performed are evaluated and the consecutive phases of diagnostic and therapeutic proceedings are examined in comparison with the knowledge in the literature.

Primary osteosarcoma of the breast: a case report

Introduction. Primary osteosarcoma of the breast is a rare soft-tissue form of osteosarcoma without involvement of the skeletal system. Due to the rarity of the disease, its clinical features and optimal treatment remain unclear. Case Presentation. This case report deals with a 62-year-old woman with pure osteosarcoma of the breast. Conclusions. The prognosis of primary osteosarcoma of the breast is poor. Recurrence is frequent, and it is often associated with haematogenous spread of the disease to the lung. Treatment follows the model of sarcomas affecting other locations and must be planned in a multidisciplinary fashion. Adjuvant chemotherapy should be considered for patients with tumors showing aggressive features.

Unilateral synchronous breast tumors. Rare association of myofibroblastoma and osteosarcoma

The authors describe the case of a patient with two particularly rare contiguous tumors, myofibroblastoma and osteosarcoma, in the same breast. Rare does not mean untreatable, and the chance of recovery is no less than with more common tumors. However, rare tumors do present a significant problem for pathologists due to diagnostic difficulties, and so an exact prognosis is not always possible.

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

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.

Extraosseous osteosarcoma in Ibadan: case series over a 20-year period

Extraosseous osteosarcoma (EOO) is a rare form of sarcoma. There have been few reports of cases and outcome from an African population.Out of 112 cases of sarcomas seen at the UCH, Ibadan between 1986-2005, 5 were EOO. All presented late on account of initial excision without histology and outcomes were poor. EOO occurs in the black population of Sub-Saharan Africa. The outlook for these patients is still bleak.

Primary osteogenic sarcoma of the breast: A case report

Introduction

Primary osteosarcoma of the breast is a rare malignant tumour. It is typically a poor prognosis tumour, which has some interesting features worthy of discussion. We report a case of primary osteosarcoma of the breast and summarise the previous medical literature to highlight several details of this unusual tumour.

Case presentation

A 66-year-old Caucasian lady presented with painless lump in her right breast. Mammography showed features of fibroadenoma with calcification and fine needle aspiration cytology was reported as showing malignant cells (C5). Wide local excision was performed and histological features were consistent with primary osteosarcoma with predominance of osteoclastic activity. Subsequent completion mastectomy was performed because of suspicion of incomplete excision. She remains disease free 8 years from her initial surgery.