Khaldi L, Athanasiou E T, Hadjitheofilou C Th
Department of Pathology, University Hospital of Larissa, Greece.
Histol Histopathol. 2007 Apr;22(4):373-7. doi: 10.14670/HH-22.373.
A 78 year-old female patient underwent a total mastectomy with axillary lymph node dissection for a primary breast osteosarcoma. Microscopically the tumor was identical to grade II skeletal osteosarcoma. Immunohistochemically no reactivity was detected, either for the epithelial markers EMA, AE1/AE3, CK8, 18, 19, or for HER-2/neu, estrogen and progesterone receptors, as well as fluorescent IN SITU hybridization for HER-2/neu. The diagnosis of this tumor fulfills certain clinicopathological criteria. Mammary osteosarcoma is usually developed in phyllodes tumors or carcinosarcomas of the breast as a result of metaplasia of the epithelial component. This rare tumor of the breast is occasionally associated with prior radiation therapy or well documented trauma. Mammary osteosarcoma is a biologically aggressive neoplasm with a 38% five-year survival rate. Surgical resection is the most effective therapy to date. Adjuvant treatment -chemotherapy or radiotherapy- has shown no clear benefit. An extensive review of the literature is also presented.
一名78岁女性患者因原发性乳腺骨肉瘤接受了全乳房切除术及腋窝淋巴结清扫术。显微镜下，肿瘤与II级骨原发性骨肉瘤相同。免疫组化检查未检测到上皮标志物EMA、AE1/AE3、CK8、18、19的反应性，也未检测到HER-2/neu、雌激素和孕激素受体的反应性，以及HER-2/neu的荧光原位杂交反应性。该肿瘤的诊断符合某些临床病理标准。乳腺骨肉瘤通常在乳腺叶状肿瘤或癌肉瘤中由上皮成分化生发展而来。这种罕见的乳腺肿瘤偶尔与既往放疗或有充分记录的创伤有关。乳腺骨肉瘤是一种具有生物学侵袭性的肿瘤，五年生存率为38%。手术切除是迄今为止最有效的治疗方法。辅助治疗——化疗或放疗——尚未显示出明显益处。本文还对文献进行了广泛综述。
