Primary leiomyosarcoma of the breast: A case report and review of literature

Abstract

Leiomyosarcomas of the breast are rare tumours. Only 18 such cases have been reported in the literature so far. We describe herein a case of primary leiomyosarcoma of the breast in a 54-year-old woman whose preoperative clinical and cytological findings indicated a benign breast tumour. However, a core needle biopsy of the lesion showed malignant spindle cells without any ductal elements. Histopathological examination of the mastectomy specimen suggested a diagnosis of leiomyosarcoma, which was subsequently confirmed by immunohistochemical analysis. Primary leiomyosarcoma of the breast is very rare and is difficult to diagnose preoperatively as it needs immuno-histochemical staining. It is necessary to excise the tumour with sufficient margins to prevent local recurrence. The role of postoperative adjuvant chemotherapy is not well documented.

Recurrent radiation-associated leiomyosarcoma after postoperative radiotherapy for breast invasive ductal carcinoma: a case report and literature review

“…Typical histological features of circumscription include high cellularity and fusiform spindle cells with blunt-ended nuclei (17). In leiomyosarcoma, tumour cells are immunoreactive for SMA, vimentin and desmin and negative for the epithelial marker S-100 and growth factor receptors (18,19). In our case, the strong expression of SMA, in addition to the typical cellular morphology, indicates the smooth muscle origin of this tumour.…”

Rare breast tumors: Review of the literature

“…Primary leiomyosarcoma of the breast: This tumor is a rare neoplasm, with less than 20 reported cases in the medical literature. 52 This tumor resembles clinically a malignant phyllodes tumor, with a firm lobulated mass. Surgery is the main approach to treatment.…”

“…The tumors may spread by direct of hematogenous invasion. 51,52 However, axillary nodal involvement is rare. 50,53 Treatment is based on a multidisciplinary approach including surgery, radiation and chemotherapy.…”

“…The axillary block dissection is usually not recommended, since none of the reported cases have shown nodal metastases. 52 Metastatic spreading usually occurs via the hematogenous route. The benefits of chemotherapy and radiotherapy have not been confirmed yet.…”

“…However, long-term follow-up is recommended because local recurrence and distant metastases may appear up to 20 years. 52…”