Kaufman M W, Marti J R, Gallager H S, Hoehn J L
Cancer. 1984 May 1;53(9):1908-17. doi: 10.1002/1097-0142(19840501)53:9<1908::aid-cncr2820530917>3.0.co;2-f.
Twenty-six cases of breast carcinoma demonstrating pseudosarcomatous metaplasia are described, and their clinical and pathologic aspects are correlated. The metaplastic elements include mature and immature bone, cartilage, myxoid stroma, loose fibromyxoid and dense spindle-cell stroma, and anaplastic stroma with giant cell features. Light and electron microscopic examination demonstrated an orderly sequence of transformation and dedifferentiation of epithelial cells to become undifferentiated mesenchymal cells. These tumors are more aggressive than purely epithelial carcinomas. The overall survival rate was 44%. Five-year survival figures for TNM Stages I, II, and III lesions were 56%, 26%, and 18%, respectively. The incidence of lymph node metastasis was 25% despite the large size of many of these tumors. Systemic metastases replicated the range of metaplastic elements seen in the primary site. Patients with tumors composed predominantly of pseudosarcomatous elements had worse prognoses than those with predominantly epithelial components (28% versus 62%, 5-year survival).
本文描述了26例表现为假肉瘤样化生的乳腺癌病例，并对其临床和病理特征进行了相关性分析。化生成分包括成熟和未成熟骨、软骨、黏液样基质、疏松纤维黏液样和致密梭形细胞基质，以及具有巨细胞特征的间变性基质。光镜和电镜检查显示上皮细胞向未分化间充质细胞转化和去分化的有序过程。这些肿瘤比单纯上皮性癌更具侵袭性。总生存率为44%。TNM I期、II期和III期病变的5年生存率分别为56%、26%和18%。尽管许多肿瘤体积较大，但淋巴结转移发生率为25%。全身转移灶复制了原发部位所见的化生成分范围。主要由假肉瘤样成分组成的肿瘤患者预后比主要由上皮成分组成的患者差（5年生存率分别为28%和62%）。
