Primary Liposarcoma of The Breast: A Report of Five Cases

Abstract

Liposarcoma of the breast is among the rarest of malignant mammary tumors. It was first described by Neumann in 1862 and accounts for 0.3% of all breast sarcomas. We reviewed in this study 5 cases of primary liposarcoma of the breast treated between 1997 and 2014 in Salah Azaiez Institute. The purpose of this study is to highlight one of the rarest and interesting variants of breast sarcoma. The patients were four women and one man. The median age at diagnostic was 50 years for the women. The man was 80 years old. The median tumor size was 6.8 cm. All liposarcomas were unilateral. Four patients underwent total mastectomy, and only one had a conservative surgery. Histologically, four tumors were classified as pleomorphic liposarcoma and one as myxoid liposarcoma. None of the patients had axillary lymph node metastases. Four patients had adjuvant treatment involving local radiation therapy, one of them had chemotherapy. None of the patients had regional or distant metastases with a median follow-up of 56 months (range, 12 to 204 months) after surgery. An immunohistochemical study should be considered to avoid misdiagnosis. The mainstay of treatment in breast liposarcoma is surgical excision. Adjuvant chemotherapy and radiation should be considered in high-risk cases.

Unusual Male Breast Lesions

“…Liposarcoma is a rare malignant breast mass accounting for <0.3% of all mammary sarcomas, and up to 20% of all malignancies of mesenchymal origin. [ 42 ] It can originate from the interlobular stromal breast tissue or develop as a component of a phyllodes tumor, with occurrence in both men and women among ages 16–75 years, and with an incidence peak age of 47 years. [ 42 - 44 ] Contrary to the phyllodes tumor, in which rapid growth is seen, liposarcoma presents clinically as a painful unilateral mass of slow growth and variable duration measuring between 8 cm (median size) reaching up to a maximum diameter of 12 cm.…”

“…In the uncommon scenario, invasion of pectoral muscle, nipple retraction, and skin changes may also be seen. [ 42 ] In histologic examination, a key characteristic in differentiating liposarcoma from others including fat necrosis is the presence of scalloped, hyperchromatic, irregular lipoblasts nuclei with intracytoplasmic vacuoles highlighted with S100 stain. [ 42 ] Depending on histological appearance, liposarcoma can be classified into five subtypes: (a) Well-differentiated, (b) pleomorphic, (c) round cell, (d) myxoid, and (e) dedifferentiated.…”

“…[ 42 ] Depending on histological appearance, liposarcoma can be classified into five subtypes: (a) Well-differentiated, (b) pleomorphic, (c) round cell, (d) myxoid, and (e) dedifferentiated. [ 42 ]…”

“…Post-operative follow-up is performed to look for (a) local recurrence, which is associated with pleomorphic liposarcoma and infiltrative margins and (b) distant metastasis. [ 42 , 43 ]…”

A dedifferentiated rare primary breast liposarcoma – case report and literature review

“…Liposarcoma is one of the most common soft tissue sarcomas (STSs) in adult people [1,2], frequently arising in the retroperitoneum and deep soft tissues of the extremities [1,3,4] and rarely seen in unusual locations like the axilla, spermatic cord, vulva, or breast [5,6]. Despite the variable histopathological (HP) features displayed by these types of tumors, five major HP subtypes are acknowledged today by the World Health Organization (WHO): atypical lipomatous tumor/well-differentiated liposarcoma (ALT/WDLPS), myxoid liposarcoma, pleomorphic liposarcoma, dedifferentiated liposarcoma (DDLPS), and myxoid pleomorphic liposarcoma, each HP subtype having different behaviors and patterns of recurrence [2,6,7].…”