Malignant Mesenchymal Tumor of the Breast: Primary Chondrosarcoma

Abstract

Background: Primary mesenchymal tumors are an extremely rare malignancy of the breast. Case Report: A 52-year-old woman presented with a rapidly growing breast mass. Physical examination established a large and round mass with regular margins in the upper-outer quadrant of the right breast. Ultrasound showed a hypoechoic solid mass (41 ×36 mm) with lobulated contours. Mammography revealed a hyperdense and relatively regular-shaped mass giving the impression of a benign tumor. However, a pathologic report of atypical cells after fine needle aspiration necessitated surgical excision. The mass was removed with a wide local excision. The tumor was diagnosed as a high-grade chondrosarcoma of the breast by histopathological analysis. Following the final diagnosis, we performed a modified radical mastectomy based on the knowledge that this malignancy is generally refractory to radiotherapy. The regional lymph nodes and local adjacent tissues were free of metastasis. The tumor was negative for estrogen and progesterone receptors as well as HER2. Conclusion: Chondrosarcoma tends to grow rapidly. Physical examination usually reveals a large, round mass. The tumor is regular-shaped, round, and complex echoic on mammography and ultrasound. It usually does not invade regional structures. Surgery remains the only effective treatment.

Carcinosarcoma of the Breast

“…They have been reported to develop from existing cystosarcoma phyllodes, fibroadenoma and cystic backgrounds [11]. Carcinosarcoma is characterized by the loss of intercellular adhesion, down-regulation of epithelial makers (cytokeratins), upregulation of mesenchymal markers [Vimentin and smooth muscle actin (SMA)], increase in motility, invasiveness, and metastatic capabilities [12][13]. In the present case, immunohistochemical staining showed the epithelial component to be positive for cytokeratin, while sarcomatous cells were positive for smooth muscle actin, and both components were positive for Vimentin.…”

Primary myxoid chondrosarcoma of the breast

“…Surgical resection remains the only curative treatment option 1–3 and adjuvant therapy was therefore not a valid option. The patient agreed with our decision and has remained disease free for 15 months.…”

Primary chondrosarcoma of the breast: a case presentation and review of the literature

“…The adjuvant treatment can decrease the rates of local and systematic recurrences, but the results are not significant because of the rarity of this pathological entity and the small number of cases reported, which makes the evaluation of the role of chemotherapy and radiotherapy in primary breast chondrosarcoma more difficult [7,9,10]. In Emad et al .’s study of malignant matrix-producing breast tumors (MP-MBC), they concluded that most MP-MBCs are variants of metaplastic breast carcinoma (MBC) with predominant mesenchymal components behaving similarly to ductal carcinomas.…”