Marinova Lena, Hadjieva Tatyana, Kanchev Emil, Vicheva Svetla
Radiotherapy Department, Oncology Hospital, Varna, Bulgaria.
Radiotherapy Department, University Hospital, Sofia, Bulgaria.
Rep Pract Oncol Radiother. 2014 May 1;20(1):72-6. doi: 10.1016/j.rpor.2014.04.003. eCollection 2015 Jan.
Primary osteogenic sarcoma of the breast is a rare neoplasm, diagnosed mainly by pathohistological and immunohistochemical analysis. We hereby present a case of primary osteogenic sarcoma in the right breast of a 62-year-old woman with synchronous appearance of an invasive ductal carcinoma. Clinical findings are manifested with two separate painless formations 2.5 cm/2 cm and 1.5 cm/1 cm in size, located on the border of the upper and lower lateral quadrant of the right breast. No axillary lymphadenopathy was diagnosed. The pathohistological and immunohistochemistry findings of both tumors revealed a synchronous manifestation of two distinct neoplasms - epithelial and non-epithelial. Multimodality treatment consisted of Patey's radical mastectomy; 3 cycles of adjuvant chemotherapy; postoperative 50 Gy radiotherapy to the chest wall followed by additional 3 cycles of chemotherapy and anti-estrogen hormonotherapy. Due to the rarity of osteogenic mammary sarcoma, even more so in a combination with epithelial breast tumors, its clinical features are unclear and optimal treatment remains controversial. Considering the poor prognosis of the combination of both malignomas, we discuss a number of diagnostic and therapeutic issues.
原发性乳腺骨肉瘤是一种罕见的肿瘤，主要通过病理组织学和免疫组织化学分析进行诊断。我们在此报告一例62岁女性右乳原发性骨肉瘤病例，同时伴有浸润性导管癌。临床表现为右乳上外象限和下外象限交界处有两个独立的无痛性肿物，大小分别为2.5厘米/2厘米和1.5厘米/1厘米。未诊断出腋窝淋巴结肿大。两种肿瘤的病理组织学和免疫组织化学检查结果显示为两种不同肿瘤（上皮性和非上皮性）的同步表现。多模式治疗包括帕蒂根治性乳房切除术；3个周期的辅助化疗；术后对胸壁进行50 Gy放疗，随后再进行3个周期的化疗和抗雌激素激素治疗。由于骨肉瘤性乳腺肉瘤罕见，尤其是与乳腺上皮性肿瘤合并出现时，其临床特征尚不清楚，最佳治疗方案仍存在争议。鉴于两种恶性肿瘤合并存在时预后较差，我们讨论了一些诊断和治疗问题。
