A huge malignant phyllodes tumor of the breast with osteoclast-like giant cells: a case report

Jiang, Lili; Li, Jiasi; Sun, Jie; Li, Haomeng; Gao, Jiyue; Li, Sushan; Li, Jun; Zhao, Hailin

doi:10.21037/gs-20-845

Cited by 7 publications

(6 citation statements)

References 16 publications

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“…Regarding the nature of OSGC in breast cancer, there is a general agreement on their histiocytic origin, as proposed for other tumor types with an OSGC component (Bonsang et al, 2019;Xu et al, 2019;Liu et al, 2021;Mori et al, 2021). Due to their multinucleated appearance and global ultrastructure, some authors have posited that OSGC are generated by a syncytial fusion of macrophages, similar to what happens to osteoclasts during osteoclastogenesis (Shishido-Hara et al, 2010;Liu et al, 2018;Liang et al, 2019;Invernizzi et al, 2020a;Inoue et al, 2021;Kao et al, 2021;Venetis et al, 2021).…”

Section: Introductionmentioning

confidence: 62%

Osteoclast-like stromal giant cells in breast cancer likely belong to the spectrum of immunosuppressive tumor-associated macrophages

Sajjadi

Gaudioso

Terrasi

et al. 2022

Front. Mol. Biosci.

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Background: Breast cancer with osteoclast-like stromal giant cells (OSGC) is an exceedingly rare morphological pattern of invasive breast carcinoma. The tumor immune microenvironment (TIME) of these tumors is populated by OSGC, which resemble osteoclasts and show a histiocytic-like immunophenotype. Their role in breast cancer is unknown. The osteoclast maturation in the bone is regulated by the expression of cytokines that are also present in the TIME of tumors and in breast cancer tumor-associated macrophages (TAMs). TAMs-mediated anti-tumor immune pathways are regulated by miRNAs akin to osteoclast homeostasis. Here, we sought to characterize the different cellular compartments of breast cancers with OSGC and investigate the similarities of OSGC with tumor and TIME in terms of morphology, protein, and miRNA expression, specifically emphasizing on monocytic signatures.Methods and Results: Six breast cancers with OSGC were included. Tumor-infiltrating lymphocytes (TILs) and TAMs were separately quantified. The different cellular populations (i.e., normal epithelium, cancer cells, and OSGC) were isolated from tissue sections by laser-assisted microdissection. After RNA purification, 752 miRNAs were analyzed using a TaqMan Advanced miRNA Low-Density Array for all samples. Differentially expressed miRNAs were identified by computing the fold change (log2Ratio) using the Kolmogorov-Smirnov test and p values were corrected for multiple comparisons using the false discovery rate (FDR) approach. As a similarity analysis among samples, we used the Pearson test. The association between pairs of variables was investigated using Fisher exact test. Classical and non-classical monocyte miRNA signatures were finally applied. All OSGC displayed CD68 expression, TILs (range, 45–85%) and high TAMs (range, 35–75%). Regarding the global miRNAs profile, OSGC was more similar to cancer cells than to non-neoplastic ones. Shared deregulation of miR-143-3p, miR-195-5p, miR-181a-5p, and miR-181b-5p was observed between OSGC and cancer cells. The monocyte-associated miR-29a-3p and miR-21-3p were dysregulated in OSGCs compared with non-neoplastic or breast cancer tissues.Conclusion: Breast cancers with OSGC have an activated TIME. Shared epigenetic events occur during the ontogenesis of breast cancer cells and OSGC but the innumophenotype and miRNA profiles of the different cellular compartmens suggest that OSGC likely belong to the spectrum of M2 TAMs.

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Section: Introductionmentioning

confidence: 62%

Osteoclast-like stromal giant cells in breast cancer likely belong to the spectrum of immunosuppressive tumor-associated macrophages

Sajjadi

Gaudioso

Terrasi

et al. 2022

Front. Mol. Biosci.

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“…Microscopically, the differential diagnosis of LMS with osteosarcomatous differentiation includes osteosarcoma, UPS, pleomorphic LMS, pleomorphic rhabdomyosarcoma, metaplastic carcinoma, myoepithelial carcinoma, malignant phyllodes tumor with heterologous elements, MPNST, angiosarcoma, choriocarcinoma and metastasis. 11 , 12 Therefore, a large panel of IHC is crucial to reach a correct diagnosis, prognostication, and management of the patients.…”

Section: Discussionmentioning

confidence: 99%

Primary leiomyosarcoma with osteosarcomatous differentiation of the breast

Sethi,

Misra,

Ahuja

2024

Autops Case Rep

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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.

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“…Laura et al performed an 11-institution contemporary review of PTs and found that there were many differences in the understanding of histopathologic features and that there were no standardized reports on the characterisation of PTs [ 11 ]. Moreover, it was found that PTs may develop in an unusual pattern-mimicking endometriosis [ 12 ], or with osteoclast-like giant cells [ 13 ]. In this study, we explored tumour heterogeneity from the early stage of tumour development.…”

Section: Discussionmentioning

confidence: 99%

Morphological features of 52 cases of breast phyllodes tumours with local recurrence

Tang

Lin

et al. 2022

Virchows Arch

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Typical phyllodes tumours (PTs) of the breast are fibroepithelial neoplasms characterised histologically by stromal hypercellularity and leaf-like structures. However, morphological changes may be atypical in some cases, increasing the difficulty of diagnosis and the likelihood of misdiagnosis. To provide more morphological clues for pathological diagnosis of PTs, we retrospectively analysed 52 PT cases with typical morphological features after recurrence, and summarized the clinicopathological characteristics of the paired primary tumours. We found five special histological features in the primary tumours distinct from classic PTs, namely (1) PTs with epithelioid feature (three cases); (2) PTs with gland-rich feature (eight cases); (3) PTs with fibroadenoma-like feature (20 cases); (4) PTs with myxoid fibroadenoma-like feature (five cases); and (5) PTs with pseudohemangiomatoid stromal hyperplasia–like feature (four cases). All the features can exist independently, and a few cases displayed more than two distinctive features at the same time. In this cohort of recurrent PTs, all the primary tumours were absent of recognisable stromal hypercellularity and leaf-like structures that are the critical diagnostic criteria of PTs; however, they showed some other non-classic characteristics which may provide significant clues for the diagnosis of PTs. Particularly, tumours with epithelioid feature displayed high grade at earlier stages, tumours with fibroadenoma-like feature were most likely to be confused with classical fibroadenomas, and tumours with myxoid feature were prone to be neglected because of their hypocellularity.

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A huge malignant phyllodes tumor of the breast with osteoclast-like giant cells: a case report

Cited by 7 publications

References 16 publications

Osteoclast-like stromal giant cells in breast cancer likely belong to the spectrum of immunosuppressive tumor-associated macrophages

Osteoclast-like stromal giant cells in breast cancer likely belong to the spectrum of immunosuppressive tumor-associated macrophages

Primary leiomyosarcoma with osteosarcomatous differentiation of the breast

Morphological features of 52 cases of breast phyllodes tumours with local recurrence

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