Ossifying Fibromyxoid Tumor of the Breast Mimicking Fibroadenoma: A Case Report and Differential Diagnoses

Abstract

An 80-year-old woman presented with a palpable mass in the right breast. Mammographic findings were consistent with calcified fibroadenoma. An ultrasound was performed that showed a solid nodule with peripheral calcification. A core biopsy was obtained that revealed a spindle cell proliferation with a shell of mature bone. The histologic features, in combination with immunohistochemical studies, were those of an ossifying fibromyxoid tumor. Complete excision of the specimen further confirmed the diagnosis. To the best of our knowledge, this is the first reported case of ossifying fibromyxoid tumor occurring in the breast. We review the current literature on ossifying fibromyxoid tumor and discuss the differential diagnoses when confronted with bland spindle cells on a core biopsy of the breast.

Fine‐needle aspiration features of ossifying fibromyxoid tumor in the breast: A case report and literature review

“…Immunohistochemical studies may be necessary to distinguish between these two neoplasms . Breast OFT should also be differentiated from metaplastic carcinoma or lobular carcinoma . Metaplastic carcinoma smears can display abundant stromal elements as in OFT smears but in metaplastic carcinoma these elements often look atypical or malignant.…”

“…OFT is a soft tissue tumor which occurs mostly in the extremities and head and neck region but it has also been reported in the breast . Cytological and histological features of typical OFT cases are quite distinctive.…”

“…17 Breast OFT should also be differentiated from metaplastic carcinoma or lobular carcinoma. 19 Metaplastic carcinoma smears can display abundant stromal elements as in OFT smears but in metaplastic carcinoma these elements often look atypical or malignant. On the other hand, tumor cells in lobular carcinoma may be similar to OFT cells but unlike OFT, lobular carcinoma smears are hypocellular and do not contain extracellular matrix.…”

“…[9][10][11][12][13][14][15] OFT is a soft tissue tumor which occurs mostly in the extremities and head and neck region but it has also been reported in the breast. 19 Cytological and histological features of typical OFT cases are quite distinctive. Usually it is not difficult to make the correct diagnosis, especially when characteristic radiological data is available.…”

An Evaluation of Ultrasound Features of Breast Fibroadenoma

“…The main reported differential diagnosis for such cases includes complicated cyst, cystosarcoma, fibromyxoid, phyllodes tumors, and breast malignancies. [ 16 17 18 19 20 ]…”