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[Radiation-Induced Undifferentiated Pleomorphic Sarcoma after Breast-Conserving Surgery-A Case Report]
Takeshi Sunami1, Kishu Kitayama, Kazunori Nakazawa
1Dept. of Surgery, PL General Hospital.
Gan to Kagaku Ryoho. Cancer & Chemotherapy
|January 20, 2021
Summary
A rare case of radiation-induced undifferentiated pleomorphic sarcoma developed in a patient 4 years after breast cancer treatment. The patient achieved long-term disease-free survival following surgical resection.
Area of Science:
- Oncology
- Surgical Pathology
Background:
- A 73-year-old woman with a history of left breast cancer treated with breast-conserving surgery and radiation therapy presented with a chest wall mass.
- The patient had undergone irradiation (50 Gy/25 Fr) to the residual breast four years prior to the current examination.
Observation:
- Computed tomography revealed a soft tissue mass on the left chest wall.
- Ultrasonography identified a hypoechoic, heterogeneous mass measuring 3.5×3.0×1.5 cm.
- Core-needle biopsy showed atypical spindle-shaped cells, leading to suspicion of undifferentiated sarcoma.
Findings:
- Immunohistochemistry was negative for common sarcoma markers (AE1/AE3, CD34, SMA, desmin, S-100) but focally positive for CD68.
- Histological examination confirmed undifferentiated pleomorphic sarcoma.
- The tumor was diagnosed as radiation-induced sarcoma based on the clinical history.
Implications:
- Wide local excision with a 3-4 cm margin was performed.
- The patient remained disease-free 54 months post-operatively, suggesting successful surgical management.
- This case highlights the importance of considering radiation-induced sarcoma in patients with a history of radiotherapy.
