Preoperative diagnosis of a giant cell tumor of soft tissue arising from the breast by ultrasound-guided core needle biopsy

Abstract

Giant cell tumors of soft tissue (GCT-ST) arising in the breast are extremely rare. Herein, we report a case of a 45-year-old woman with a 5-cm mass in her left breast. Ultrasonography revealed a mainly well-circumscribed mass that contained a cystic lesion. Magnetic resonance imaging showed a fibrous capsule-covered mass that contained a high-intensity area, suggesting hemorrhaging. Ultrasound-guided core needle biopsy (CNB) revealed mononuclear histiocytic cells with a round shape or spindled appearance that was mixed with multinucleated giant cells. Immunohistochemical analysis revealed CD68-positive staining in the mononuclear and giant cells but negative staining for pancytokeratin. Preoperatively, the tumor was highly suspected of being GCT-ST. Histopathological results after a left mastectomy showed similar findings to CNB. The final diagnosis was GCT-ST in the breast. To the best of our knowledge, this is the first case report of a GCT-ST arising in the breast diagnosed by ultrasound-guided CNB.

Primary Giant Cell Tumor of the Breast With Pulmonary Metastasis: A Case Report and Review of the Literature

“…Tumors ranged in size from 2.5 to 13 cm with a median size of 4.7 cm. The first symptom of the nine patients was a breast mass, of which one was accompanied by nipple discharge (7). All patients underwent surgery, only one patient had features of lung metastasis and a fatal outcome (10).…”

“…Reviewing previous reports on nine cases of GCT-ST of the breast, all nine patients underwent surgical treatment: one patient had excisional biopsy only, one patient underwent wide local excision, and the remaining seven patients underwent mastectomy. Among these patients, three patients received sentinel lymph node biopsy (5,6,12) and two patients had axillary lymph node dissection (7,13). All five of these had no axillary lymph node metastasis.…”

Primary giant cell tumour of the breast with recurrence: A rare case report

“…Microscopically, giant cell tumours (GCTs) are diagnosed when an even distribution of multinucleated osteoclast-like giant cells (OGCs) are noted surrounded by oval and spindle mononuclear cells. 1 They usually occur in the epiphysis of skeletally mature long bones and are called GCT of the soft tissues (GCT-ST) when they occur in the soft tissue instead of bone. 1 Giant cell tumours of the soft tissues are usually found in the superficial and deep soft tissues of the extremities but have been described in the pancreas, lung, thyroid gland, urothelial tract, skin, larynx, heart and very rarely, in the breast.…”

“… 1 Giant cell tumours of the soft tissues are usually found in the superficial and deep soft tissues of the extremities but have been described in the pancreas, lung, thyroid gland, urothelial tract, skin, larynx, heart and very rarely, in the breast. 1 , 2 …”

“…3 However, primary GCT of the breast resembling the one found in bone, and not related to underlying breast carcinoma is extremely rare with only eight other cases found, described in the literature between 1981 and 2020. 1 , 2 , 4 , 5 , 6 , 7 , 8 , 9 …”