Primary leiomyosarcoma with osteosarcomatous differentiation of the breast

Ekta Sethi; Sunayana Misra; Arvind Ahuja

doi:10.4322/acr.2024.476

Clinical Case Report

Primary leiomyosarcoma with osteosarcomatous differentiation of the breast

Ekta Sethi; Sunayana Misra; Arvind Ahuja

http://dx.doi.org/10.4322/acr.2024.476 Autops Case Rep, vol.14, e2024476, 2024

PDF

Downloads: 5

Abstract

Primary leiomyosarcoma with osteosarcomatous differentiation of the breast is an uncommon entity. We present the case of a 37-year-old female who presented with a lump in the breast and pulmonary lesions on PET-CT, for which she underwent a toilet mastectomy. Histopathological examination revealed a tumor with cells arranged in sheets. These tumor cells had moderate eosinophilic cytoplasm, highly pleomorphic, irregular hyperchromatic nuclei, coarse chromatin, and prominent nucleoli. Areas with spindle-cell morphology were noted. Osteoid was seen intermingling with the tumor along with numerous osteoclast-like multinucleate giant cells. A wide panel of Immunohistochemistry was applied, and Desmin, h-Caldesmon, SMA, and Vimentin were positive. The patient died 3 months post-surgery and had a recurrence at the surgical site.

Keywords

Breast, Leiomyosarcoma, Mastectomy, Sarcoma

References

1 Shinto O, Yashiro M, Yamada N, et al. Primary leiomyosarcoma of the breast: report of a case. Surg Today. 2002;32(8):716-9. http://dx.doi.org/10.1007/s005950200133. PMid:12181723.

2 Oktay Y, Fikret A. Leiomyosarcoma of the breast. J Surg Case Rep. 2011;2011(7):1. http://dx.doi.org/10.1093/jscr/2011.7.1. PMid:24950039.

3 Ilyas MIM, Nazir S, Xiao PQ. Breast leiomyosarcoma: a systematic review and recommendations for management. Int Surg. 2019;104(5):196-202. http://dx.doi.org/10.9738/INTSURG-D-15-00183.1.

4 Mentzel T, Fletcher CDM. Malignant mesenchymomas of soft tissue associated with numerous osteoclast-like giant cells mimicking the so-called giant cell variant of “malignant fibrous histiocytoma”. Virchows Arch. 1994;424(5):539-45. http://dx.doi.org/10.1007/BF00191441. PMid:8032534.

5 Grabellus F, Sheu SY, Schmidt B, et al. Recurrent high-grade leiomyosarcoma with heterologous osteosarcomatous differentiation. Virchows Arch. 2006;448(1):85-9. http://dx.doi.org/10.1007/s00428-005-0094-0. PMid:16228225.

6 Chen E, O’Connell F, Fletcher CD. Dedifferentiated leiomyosarcoma: clinicopathological analysis of 18 cases. Histopathology. 2011;59(6):1135-43. http://dx.doi.org/10.1111/j.1365-2559.2011.04070.x. PMid:22175893.

7 Feeley C, Gallagher P, Lang D. Osteosarcoma arising in metastatic leiomyosarcoma. Histopathology. 2005;46(1):111-3. http://dx.doi.org/10.1111/j.1365-2559.2005.01983.x. PMid:15656897.

8 Gaeta R, Matera D, Muratori F, et al. Dedifferentiated soft tissue leiomyosarcoma with heterologous osteosarcoma component: case report and review of the literature. Clin Sarcoma Res. 2020;10(1):6. http://dx.doi.org/10.1186/s13569-020-00129-5. PMid:32280451.

9 Yu S, Hornick JL. “Malignant Mesenchymoma” revisited: a clinicopathologic study of leiomyosarcomas with osteosarcomatous differentiation. Am J Surg Pathol. 2022;46(10):1430-5. http://dx.doi.org/10.1097/PAS.0000000000001928. PMid:35687345.

10 Galama R, Matoso J, Capela G, Boto C, Duarte C, Mendes AR. A rare etiology of a large tumoral mass of the breast- Case report primary leiomyosarcoma and osteosarcoma of the breast. Int J Surg Case Rep. 2021;78:201-3. http://dx.doi.org/10.1016/j.ijscr.2020.12.050. PMid:33360630.

11 Luh SP, Wong LC, Huang PC, Huang CS. Primary leiomyosarcoma of the nipple-areola complex: report of a case and review of literature. J Zhejiang Univ Sci B. 2008;9(2):109-13. http://dx.doi.org/10.1631/jzus.B0720246. PMid:18257132.

12 Liu T, Jiang L, Li J, et al. A huge malignant phyllodes tumor of the breast with osteoclast-like giant cells: a case report. Gland Surg. 2021;10(4):1508-14. http://dx.doi.org/10.21037/gs-20-845. PMid:33968702.

Submitted date:
01/09/2024

Accepted date:
01/31/2024

Publication date:
02/26/2024

Primary leiomyosarcoma with osteosarcomatous differentiation of the breast

Ekta Sethi; Sunayana Misra; Arvind Ahuja

Abstract

Keywords

References

Links

Share

Autops Case Rep