Ann Surg Treat Res.  2017 Jul;93(1):57-60. 10.4174/astr.2017.93.1.57.

Primary osteosarcoma of the breast: a case report

• Yoon CS
• Kang SS

• KMID: 2392284
• DOI: http://doi.org/10.4174/astr.2017.93.1.57

Abstract

Primary osteosarcomas of the breast are extremely uncommon. Here we describe a case of a 77-year-old woman who presented with a hard mass on her right breast. Mammography and breast ultrasound demonstrated a round-shaped calcified mass on the right breast but the features were not definitely diagnostic. For diagnostic purposes, an excisional biopsy was performed and the mass proved to be a primary osteosarcoma of the breast by pathologic findings. PET-CT and whole body bone scan showed neither evidence of metastasis nor underlying bone lesions. Wide excision without axillary lymph node dissection was performed after diagnosis. Further treatment such as adjuvant chemotherapy or radiation therapy was not performed. We discuss proper treatment of this rare type of breast cancer.

Keyword

Osteosarcoma; Breast; Local excision

Figure

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  Fig. 1 Mammography on both breasts. A 2-cm-sized calcified mass on right upper deep portion. RT, right; LT, left; CC, craniocaudal view; MLO, mediolateral oblique view.

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  Fig. 2 About 2.3-cm-sized calcified low echoic mass with posterior acoustic shadowing was noted at 1 o'clock in right upper breast on breast ultrasound.

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  Fig. 3 (A) Malignant tumor shows neoplastic bone composed of calcification with osteoid (left) and irregular trabeculae having tumor cells (right). Malignant osteoid bone intimately associated with tumor cells (H&E, ×100). (B) Neoplastic bone is intimately admixed with malignant tumor cells (H&E, ×100). (C) Tumor cells are composed of highly pleomorphic stromal cells (left) and spindle cells (right). Main histological variants are osteoblastic and osteoclastic (giant, cell-rich) subtypes (H&E, ×100). (D) Plasmacytoid sarcoma cells have hyperchormatic nuclei, conspicuous nucleoli and abundant eosinophilic cytoplasm, with frequent mitoses (H&E, ×400). (E) Spindle cell sarcoma shows pleomorphic stromal cells and frequent mitoses (H&E, ×400). (F) The tumor margin reveals partly infiltrative growth (H&E, ×100).

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  Fig. 4 No evidence of bone metastasis, no underlying bone lesion on whole body bone scan. Postexcision state.

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  Fig. 5 No evidence of distant metastasis, no underlying bone lesion on PET-CT. Postexcision state.

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