Gurleyik Emin, Yildirim Umran, Gunal Omer, Pehlivan Mevlut
Department of Surgery, Medical Faculty, Duzce University, Turkey.
Breast Care (Basel). 2009;4(2):101-103. doi: 10.1159/000212101. Epub 2009 Apr 24.
BACKGROUND: Primary mesenchymal tumors are an extremely rare malignancy of the breast. CASE REPORT: A 52-year-old woman presented with a rapidly growing breast mass. Physical examination established a large and round mass with regular margins in the upper-outer quadrant of the right breast. Ultrasound showed a hypoechoic solid mass (41 × 36 mm) with lobulated contours. Mammography revealed a hyperdense and relatively regular-shaped mass giving the impression of a benign tumor. However, a pathologic report of atypical cells after fine needle aspiration necessitated surgical excision. The mass was removed with a wide local excision. The tumor was diagnosed as a high-grade chondrosarcoma of the breast by histopathological analysis. Following the final diagnosis, we performed a modified radical mastectomy based on the knowledge that this malignancy is generally refractory to radiotherapy. The regional lymph nodes and local adjacent tissues were free of metastasis. The tumor was negative for estrogen and progesterone receptors as well as HER2. CONCLUSION: Chondrosarcoma tends to grow rapidly. Physical examination usually reveals a large, round mass. The tumor is regular-shaped, round, and complex echoic on Mammography and ultrasound. It usually does not invade regional structures. Surgery remains the only effective treatment.
背景：原发性间充质肿瘤是一种极其罕见的乳腺恶性肿瘤。病例报告：一名52岁女性因右乳肿块迅速增大就诊。体格检查发现右乳外上象限有一个边界规则的大圆形肿块。超声显示一个低回声实性肿块（41×36mm），轮廓呈分叶状。乳腺钼靶显示一个高密度且形状相对规则的肿块，给人一种良性肿瘤的印象。然而，细针穿刺后的病理报告显示有非典型细胞，因此需要手术切除。通过广泛局部切除将肿块切除。经组织病理学分析，该肿瘤被诊断为乳腺高级别软骨肉瘤。在最终诊断后，鉴于这种恶性肿瘤通常对放疗不敏感，我们进行了改良根治性乳房切除术。区域淋巴结和局部相邻组织无转移。肿瘤的雌激素、孕激素受体以及HER2均为阴性。结论：软骨肉瘤往往生长迅速。体格检查通常发现一个大的圆形肿块。在乳腺钼靶和超声检查中，肿瘤形状规则、呈圆形且回声复杂。它通常不侵犯区域结构。手术仍然是唯一有效的治疗方法。
