Primary Breast Liposarcoma

Imaging Features of the Mesenchymal Tumors of the Breast according to WHO Classification: A Pictorial Essay

Mesenchymal tumors of the breast, which originate from the mammary stroma, are rare accounting for only approximately 0.5%-1% of all breast tumors. Pathologically, they can exist on a spectrum, ranging from benign to malignant. Such tumors may present with nonspecific findings on breast imaging, including mammography, ultrasound, and MRI, which can lead to diagnostic challenges. In the 2019 revised 5th edition of the World Health Organization classification, breast mesenchymal tumors are categorized into six groups. The current pictorial essay aimed to explore the clinical, pathological, and imaging characteristics of representative lesions in each category according to this six-group classification, with the ultimate goal of enhancing awareness for early diagnosis.

Extremely Rare Type of Breast Cancer-Dedifferentiated Breast Liposarcoma-Diagnosis and Treatment

Primary liposarcoma of the breast is an uncommon soft tissue malignant tumor, comprising only 0.003% of all malignant breast tumors. The main differential diagnosis of this mass consists of malignant phyllodes tumor and metaplastic breast carcinoma. The objective of this paper is to report a case of dedifferentiated breast liposarcoma, therapeutic approach and outcome. We present a case of a 79-year-old woman complaining of a large mass in her left breast which had increased in size over the last 6 months. Physical examination revealed an enlarged left breast, and a total body CT scan showed a large tumor in contact with the musculature of the anterior thoracic wall, with no metastatic lesions. The histopathology report of a fine needle biopsy described a high-grade sarcoma. The Oncological Tumor Board recommended neoadjuvant radiotherapy sessions and reevaluation by MRI and CT scans. The patient underwent radical mastectomy with latissimus dorsi myo-cutaneous flap reconstruction. The final histopathology diagnosis was a grade 3 dedifferentiated liposarcoma (FNCLCC), with certain response to radiotherapy and positive MDM2, CDK4 markers. The postoperative period was uneventful; 12 months after surgery, the follow-up CT scan showed multiple pulmonary lesions with metastatic characteristics. Liposarcoma is a very rare type of breast cancer, and the most important treatment for breast sarcoma is surgery, the role of axillary lymph node removal, chemotherapy and radiotherapy still being controversial. Considering such cases are scarce and the development of surgical guidelines is difficult, reporting any new case is crucial.

Initial Imaging Findings of Breast Liposarcoma: A Case Report

Liposarcoma of the breast is a rare form of cancerous tumor that can be mistaken for primary breast cancer. A recent instance involved a woman who was 54 years old and went in for her annual screening mammogram. The mammogram revealed that she had a 1 cm focal asymmetry of equal density in her right axillary tail, approximately 9 cm from the nipple. After nine months, the patient observed a rapidly growing mass even though the initial ultrasound scan did not detect anything unusual. A targeted mammogram demonstrated a large and dense mass confined to the right axillary tail, followed by an ultrasound scan that revealed a heterogeneous hyperechoic, echogenic mass. Histopathology after surgery showed that the patient had an undifferentiated pleomorphic breast liposarcoma. This diagnosis was reached after the patient underwent surgery.Liposarcoma of the breast is a concerning condition that needs careful management and close monitoring, although it is relatively uncommon. Early detection of the patient's condition and prompt treatment can help improve the patient's prognosis. This can be accomplished by remaining vigilant with routine screenings and following up on any unusual findings or changes in breast tissue. However, it is possible to diagnose this condition as primary breast cancer incorrectly; consequently, healthcare providers need to conduct comprehensive evaluations to ensure diagnostic accuracy and the delivery of appropriate treatment.

Primary dedifferentiated liposarcoma of the breast: A case report

Primary breast liposarcoma is an extraordinarily rare breast malignancy. Histological subtypes including dedifferentiated are confirmed after a thorough histopathological and immunohistochemistry analysis. Liposarcoma of the breast can mimic other breast lesions. Long-term follow-up is needed due to the risk of local recurrence and delayed dedifferentiation.

Effective Treatment for Primary Locally Aggressive Intermediate and Malignant Soft Tissue Tumors of the Breast

Objective

This study aimed to examine the rare locally aggressive intermediate tumors and malignant primary breast mesenchymal tumors in patients receiving surgical treatment.

Summary of background data

Locally aggressive intermediate tumors were subdivided into nonmetastasizing and rarely metastasizing, and the malignant group was subdivided as a single subgroup called able to metastasize. A retrospective examination of surgical notes and clinical charts was carried out reviewing gender, age, symptoms, duration of symptoms, tumor size, clinical presentation, radiation history, kind of surgery undergone, adjuvant radiotherapy, adjuvant chemotherapy, local recurrences, systemic metastases, and mortality.

Results

Mitotic index and Ki-67 were statistically different between locally aggressive and malignant groups (P < 0.001). One local recurrence occurred in only 1 patient diagnosed as dermatofibrosarcoma protuberans among all patients. None of the entities showed distant metastasis or mortality. In this result, clear margin of surgery in locally aggressive intermediate group and combination of surgery with radiation therapy in the malignant group was the most important determinant for the prospect of the patients with mean follow-up of 28 months.

Conclusion

The main treatment for localized mesenchymal breast tumors is surgery. When the disease is locally advanced or malignant with high mitotic index, radiotherapy with surgery is predominantly used. Targeted therapies are promising with the limited place of chemotherapy.