Lipoblastoma is a rare, benign tumor usually occurring in childhood. It is essentially localized in the extremities and trunk, with few cases reported in the neck. We report the case of a 2-year-old girl with a rapidly enlarging, painless neck mass. Magnetic resonance imaging (MRI) revealed a 3-cm mass in the right submandibular region. Review of literature, diagnostic methods, and genetics of lipomatous tumors are discussed. Complete surgical excision via a lateral cervical approach demonstrated a white soft tissue with an adherent ganglion. Histology and immunohistochemistry confirmed the diagnosis of lipoblastoma. Cervical lipoblastoma is rare, and typically asymptomatic, rarely causing nerve compression or airway obstruction. MRI can help identifying the lipomatous nature of the mass, but the findings can be inconsistent due to variable maturity of fat cells and the mesenchymal content of the tumor. Diagnosis is always based on pathological examination. Further chromosomal analysis is useful in differentiating lipoblastoma from liposarcoma. Complete surgical excision is the recommended treatment.
Liposarcoma of the breast is among the rarest of malignant mammary tumors. It was first described by Neumann in 1862 and accounts for 0.3% of all breast sarcomas. We reviewed in this study 5 cases of primary liposarcoma of the breast treated between 1997 and 2014 in Salah Azaiez Institute. The purpose of this study is to highlight one of the rarest and interesting variants of breast sarcoma. The patients were four women and one man. The median age at diagnostic was 50 years for the women. The man was 80 years old. The median tumor size was 6.8 cm. All liposarcomas were unilateral. Four patients underwent total mastectomy, and only one had a conservative surgery. Histologically, four tumors were classified as pleomorphic liposarcoma and one as myxoid liposarcoma. None of the patients had axillary lymph node metastases. Four patients had adjuvant treatment involving local radiation therapy, one of them had chemotherapy. None of the patients had regional or distant metastases with a median follow-up of 56 months (range, 12 to 204 months) after surgery. An immunohistochemical study should be considered to avoid misdiagnosis. The mainstay of treatment in breast liposarcoma is surgical excision. Adjuvant chemotherapy and radiation should be considered in high-risk cases.
Background: Metaplastic carcinoma of the breast is a rare entity containing a mixture of malignant epithelial and mesenchymal elements. The World Health Organization only recognized it as a distinct pathological entity since 2000. The aim of this study is to better characterize this rare disease.Methods: We reviewed retrospectively 15 cases of metaplastic carcinoma of the breast treated in our institute between 1994 and 2015. We analyzed clinical, histological, therapeutic and evolutive data.Results: All patients were females ranging from 29 to 75 years old (median, 50). Tumor size ranged from 20 to 150 mm (median, 72 mm). The Treatment consisted of radical mastectomy in 14 cases, often combined with post-operative radiation and/or chemotherapy. There were 8 cases of carcinosarcoma, 4 cases of spindle cell carcinoma and 3 cases of squamous cell carcinoma. Follow-up data were available on 12 patients. The median follow-up was 47 months (range, 10 to 146 months). Definitive nodal metastases were identified in 6 cases. One patient developed a local recurrence. Extranodal metastases occurred in 3 patients. Three patients died at median interval of 20 months (range, 13-30). Eight patients were alive with no evidence of recurrent or metastatic disease (median, 47 months) and one patient was alive with metastatic disease.Conclusions: Based on this series, metaplastic breast carcinoma is characterized by a large tumor size at presentation, a low frequency of nodal metastases and a high proportion of triple negativity. Our series is consistent with the literature.
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