Pathology Unit, Medical and Surgical Sciences Department, University of Cantabria and IDIVAL Research Institute, Avda. Cardenal Herrera Oria s/n, 39011, Santander, Spain.
Service of Anatomical Pathology, Marqués de Valdecilla University Hospital and IDIVAL Research Institute, Santander, Spain.
Pathol Res Pract. 2019 Dec;215(12):152664. doi: 10.1016/j.prp.2019.152664. Epub 2019 Oct 1.
Myofibroblastic sarcoma (MFS) is an uncommon tumor rarely located in the breast. Ionizing radiation is a carcinogen capable of inducing sarcomas through DNA damage. A 42-year-old woman was diagnosed with synchronous bilateral breast infiltrating ductal carcinoma with axillary lymph node metastases on the left side. After modified left radical mastectomy and simple right mastectomy, she underwent postoperative radiation with a total volume dose of 50 Gy that included the thoracic wall and the left axillary-supraclavicular region. After a latency period of 6 years and 4 months, the patient developed an MFS in the area of radiation (mammary upper outer quadrant). To our knowledge, only 11 cases of MFS have been previously published in the breast. The study of the 12 cases including the present one revealed that the ages of the patients ranged from 42 to 86 years (mean 60.3 years). There was a clear difference concerning sex (M:F, 1:5). The average duration of the lesion varied from 1 week to 8 months (mean 3.3 months). The size ranged from 2.2 to 22 cm (average 5.1 cm). The tumors showed frequent mitosis and areas of necrosis. The percentage of recurrences, metastasis, and death due to the tumor was 27.3%, 36.4%, and 27.3% respectively. MFS cases differ from those affecting extramammary regions. They are more common in females and show a greater degree of aggressiveness. Correct diagnosis of mammary MFS requires morphological and immunohistochemical study. We present for the first time a case of MFS of the breast induced by radiotherapy.
肌纤维母细胞肉瘤（MFS）是一种罕见的肿瘤，很少发生在乳房。电离辐射是一种致癌物质，能够通过 DNA 损伤诱导肉瘤。一位 42 岁的女性被诊断为左侧同步双侧乳腺浸润性导管癌伴腋窝淋巴结转移。在接受改良左侧根治性乳房切除术和单纯右侧乳房切除术之后，她接受了术后放疗，总剂量为 50Gy，包括胸壁和左侧腋窝锁骨上区域。6 年零 4 个月后，患者在放疗区域（乳房上部外象限）发生 MFS。据我们所知，之前仅有 11 例 MFS 发生在乳房。包括本病例在内的 12 例研究显示，患者年龄为 42 至 86 岁（平均 60.3 岁）；性别存在明显差异（男：女，1：5）。病变的平均持续时间从 1 周到 8 个月不等（平均 3.3 个月）。肿瘤大小从 2.2 至 22cm 不等（平均 5.1cm）。肿瘤表现为频繁的有丝分裂和坏死区。因肿瘤导致的复发率、转移率和死亡率分别为 27.3%、36.4%和 27.3%。发生于乳房的 MFS 病例与发生于乳腺外区域的病例不同。它们在女性中更为常见，且侵袭性更强。对乳腺 MFS 的正确诊断需要进行形态学和免疫组织化学研究。我们首次报告了一例由放疗引起的乳房 MFS 病例。
