Primary leiomyosarcoma with osteosarcomatous differentiation of the breast
DOI:
https://doi.org/10.4322/acr.2024.476Keywords:
Breast, Leiomyosarcoma, Mastectomy, SarcomaAbstract
Primary leiomyosarcoma with osteosarcomatous differentiation of the breast is an uncommon entity. We present the case of a 37-year-old female who presented with a lump in the breast and pulmonary lesions on PET-CT, for which she underwent a toilet mastectomy. Histopathological examination revealed a tumor with cells arranged in sheets. These tumor cells had moderate eosinophilic cytoplasm, highly pleomorphic, irregular hyperchromatic nuclei, coarse chromatin, and prominent nucleoli. Areas with spindle-cell morphology were noted. Osteoid was seen intermingling with the tumor along with numerous osteoclast-like multinucleate giant cells. A wide panel of Immunohistochemistry was applied, and Desmin, h-Caldesmon, SMA, and Vimentin were positive. The patient died 3 months post-surgery and had a recurrence at the surgical site.
Downloads
References
Shinto O, Yashiro M, Yamada N, et al. Primary leiomyosarcoma of the breast: report of a case. Surg Today. 2002;32(8):716-9. http://dx.doi.org/10.1007/s005950200133. PMid:12181723.
Oktay Y, Fikret A. Leiomyosarcoma of the breast. J Surg Case Rep. 2011;2011(7):1. http://dx.doi.org/10.1093/jscr/2011.7.1. PMid:24950039.
Ilyas MIM, Nazir S, Xiao PQ. Breast leiomyosarcoma: a systematic review and recommendations for management. Int Surg. 2019;104(5):196-202. http://dx.doi.org/10.9738/INTSURG-D-15-00183.1.
Mentzel T, Fletcher CDM. Malignant mesenchymomas of soft tissue associated with numerous osteoclast-like giant cells mimicking the so-called giant cell variant of “malignant fibrous histiocytoma”. Virchows Arch. 1994;424(5):539-45. http://dx.doi.org/10.1007/BF00191441. PMid:8032534.
Grabellus F, Sheu SY, Schmidt B, et al. Recurrent high-grade leiomyosarcoma with heterologous osteosarcomatous differentiation. Virchows Arch. 2006;448(1):85-9. http://dx.doi.org/10.1007/s00428-005-0094-0. PMid:16228225.
Chen E, O’Connell F, Fletcher CD. Dedifferentiated leiomyosarcoma: clinicopathological analysis of 18 cases. Histopathology. 2011;59(6):1135-43. http://dx.doi.org/10.1111/j.1365-2559.2011.04070.x. PMid:22175893.
Feeley C, Gallagher P, Lang D. Osteosarcoma arising in metastatic leiomyosarcoma. Histopathology. 2005;46(1):111-3. http://dx.doi.org/10.1111/j.1365-2559.2005.01983.x. PMid:15656897.
Gaeta R, Matera D, Muratori F, et al. Dedifferentiated soft tissue leiomyosarcoma with heterologous osteosarcoma component: case report and review of the literature. Clin Sarcoma Res. 2020;10(1):6. http://dx.doi.org/10.1186/s13569-020-00129-5. PMid:32280451.
Yu S, Hornick JL. “Malignant Mesenchymoma” revisited: a clinicopathologic study of leiomyosarcomas with osteosarcomatous differentiation. Am J Surg Pathol. 2022;46(10):1430-5. http://dx.doi.org/10.1097/PAS.0000000000001928. PMid:35687345.
Galama R, Matoso J, Capela G, Boto C, Duarte C, Mendes AR. A rare etiology of a large tumoral mass of the breast- Case report primary leiomyosarcoma and osteosarcoma of the breast. Int J Surg Case Rep. 2021;78:201-3. http://dx.doi.org/10.1016/j.ijscr.2020.12.050. PMid:33360630.
Luh SP, Wong LC, Huang PC, Huang CS. Primary leiomyosarcoma of the nipple-areola complex: report of a case and review of literature. J Zhejiang Univ Sci B. 2008;9(2):109-13. http://dx.doi.org/10.1631/jzus.B0720246. PMid:18257132.
Liu T, Jiang L, Li J, et al. A huge malignant phyllodes tumor of the breast with osteoclast-like giant cells: a case report. Gland Surg. 2021;10(4):1508-14. http://dx.doi.org/10.21037/gs-20-845. PMid:33968702.
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Autopsy and Case Reports

This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright
Authors of articles published by Autopsy and Case Report retain the copyright of their work without restrictions, licensing it under the Creative Commons Attribution License - CC-BY, which allows articles to be re-used and re-distributed without restriction, as long as the original work is correctly cited.