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Primary Osteosarcoma of the Breast
Prashant Balwant Kerkar1, Garima Daga1
1Department of Surgical Oncology, Bombay Hospital, Bombay hospital Marg, Marine Drive, Mumbai, Maharashtra 400020 India.
Indian Journal of Surgical Oncology
|December 13, 2018
Summary
Extraskeletal osteosarcomas are rare soft tissue tumors. This case highlights a primary breast osteosarcoma, emphasizing the need for accurate diagnosis and multimodal management due to its poor prognosis.
Area of Science:
- Oncology
- Pathology
- Surgical Oncology
Background:
- Extraskeletal osteosarcomas are rare, comprising less than 1% of soft tissue sarcomas.
- Primary breast osteosarcoma is exceptionally rare, with limited reported cases.
- These tumors are associated with a poor prognosis due to high recurrence and metastasis rates.
Observation:
- A 44-year-old female presented with a large (14x10 cm) solid mass in her right breast.
- Initial frozen section suggested metaplastic carcinoma; axillary dissection was performed.
- Final histopathology confirmed high-grade osteogenic sarcoma with specific cellular and matrix features.
Findings:
- Histopathology revealed haphazardly arranged spindle to stellate cells with giant cells.
- The matrix showed evidence of osteoid and cartilaginous differentiation.
- Immunohistochemistry (IHC) was crucial, with tumor cells positive for Vimentin, EMA, Pankeratin, and P63; negative for ER, PR, Her2neu, CK7, CK8/18, and CK34.
Implications:
- Accurate recognition of this rare tumor variant is critical for appropriate treatment planning.
- Multimodal management strategies are necessary for primary breast osteosarcoma.
- Immunohistochemistry is vital for diagnosis and guiding subsequent patient management.
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