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乳腺原发性未分化多形性肉瘤:1例病例报告并文献复习类似病例

Primary Undifferentiated Pleomorphic Sarcoma of the Breast: A Case Report with Literature Review of Similar Cases.

作者信息

Jafarian Amirhossein, Shahraki Mohaddeseh, Sajjadi Samaneh, Daneshmand Behrooz

机构信息

Cancer Molecular Research Center , Mashhad University of Medical Sciences, Mashhad, Iran.

Department of Pathology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

出版信息

Iran J Pathol. 2024 Winter;19(1):118-125. doi: 10.30699/IJP.2023.2006411.3139. Epub 2023 Dec 29.

Abstract

Breast sarcoma is a rare but aggressive tumor. There are few case reports in the literature and several aspects of this disease are still not completely comprehended. Therefore, reporting new cases can help to enrich the literature. We report a patient with breast mass and pus secretion from her right breast, misdiagnosed as an abscess and mistreated by antibiotics. The patient was referred for an ultrasound examination and mammography, and a needle biopsy was performed that suggested an aggressive tumor. By the pathologist's suggestion, a total mastectomy of the right breast was performed with the excision of sentinel nodes. A pathological examination revealed a high-grade undifferentiated pleomorphic sarcoma (UPS) without vascular or lymph node invasion as the final diagnosis. The patient underwent postoperative chemotherapy and is currently in good condition. This case emphasizes considering this rare tumor when approaching a breast mass. Performing surgery with adequate resection margin can improve the patient's prognosis. Some suggested breast UPS cases with lung and brain metastasis would be more aggressive tumors than other breast sarcomas. Total mastectomy with negative margins and free-of-tumor lymph nodes may be the key to improve prognosis in such patients.

摘要

乳腺肉瘤是一种罕见但侵袭性强的肿瘤。文献中的病例报告较少,该疾病的几个方面仍未被完全理解。因此,报告新病例有助于丰富文献。我们报告了一名有右乳肿块和脓性分泌物的患者,最初被误诊为脓肿并接受了抗生素治疗。患者接受了超声检查和乳腺钼靶检查,并进行了穿刺活检,结果提示为侵袭性肿瘤。根据病理学家的建议,对患者实施了右乳全乳房切除术及前哨淋巴结切除。病理检查最终诊断为高级别未分化多形性肉瘤(UPS),无血管或淋巴结侵犯。患者术后接受了化疗,目前状况良好。该病例强调在处理乳腺肿块时应考虑到这种罕见肿瘤。进行具有足够切缘的手术可以改善患者的预后。一些报道的伴有肺和脑转移的乳腺UPS病例可能比其他乳腺肉瘤更具侵袭性。切缘阴性且无肿瘤转移淋巴结的全乳房切除术可能是改善此类患者预后的关键。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2790/11164308/8179d4b5a1a9/ijp-19-118-g001.jpg

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