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Case Reports in Oncology 2024Spindle cell sarcomas are rare breast lesions which are difficult to diagnose due to resemblance with other breast lesions. Histopathological examination and...
INTRODUCTION
Spindle cell sarcomas are rare breast lesions which are difficult to diagnose due to resemblance with other breast lesions. Histopathological examination and immunohistochemical staining are essential for diagnosis.
CASE PRESENTATION
We present a rare case of a 15-year-old female presenting with high-grade rapidly progressive spindle cell sarcoma of the breast, differentiated as phyllodes tumor, with axillary lymph node involvement. Her lesion, on the left breast, measured 16.9 × 10.1 × 13.7 cm. Histology revealed malignant neoplasm arranged in sheets and individual neoplastic cells with an epithelioid to spindled morphology with scant cytoplasm and irregular nuclear membranes. Immunohistochemistry showed weakly positive focal CD-99, and negative WT-1, Myogenin, Desmin, p63, Cytokeratin, Synaptophysin, and CD-34 markers. She was successfully managed with modified radical mastectomy and discharged with regular follow-up advised.
CONCLUSION
Spindle cell sarcomas have a very aggressive course and prompt diagnosis, and management is mandatory for better patient outcomes. Modified radical mastectomy is the mainstay of treatment.
PubMed: 38333631
DOI: 10.1159/000536125 -
Cureus May 2024Histiocytic sarcoma (HS) is a rare cancerous tumor that originates from fully developed histiocytes. It is most often identified by the presence of certain proteins such...
Histiocytic sarcoma (HS) is a rare cancerous tumor that originates from fully developed histiocytes. It is most often identified by the presence of certain proteins such as the cluster of differentiation (CD) 68, CD163, or lysozyme. HS has been recorded in different sites outside of the lymph nodes such as the gastrointestinal tract, nasal cavities, skin, and bone marrow. Because HS shares similar clinical features with other forms of malignant diseases, diagnosing it becomes incredibly challenging. We report a case of a 40-year-old female who presented with a breast mass for one year. A preliminary diagnosis of a phyllodes tumor was made. However, the morphology along with the immunophenotype picture was diagnostic for HS. Microscopic features showed a well-defined neoplastic growth arranged in sheets and fascicles. Diffuse immunoreactivity was seen for CD45, CD4, CD68, CD163, and vimentin. We present the important histopathological and immunohistochemical characteristics of the tumor in this case.
PubMed: 38836132
DOI: 10.7759/cureus.59677 -
BMJ Case Reports Mar 2024A young woman in her 20s was found to have a left breast malignant phyllodes tumour by ultrasound-guided core needle biopsy, after identifying a palpable lump. She then...
A young woman in her 20s was found to have a left breast malignant phyllodes tumour by ultrasound-guided core needle biopsy, after identifying a palpable lump. She then underwent lumpectomy excision with >1 cm gross margins; however, final pathology demonstrated <1 cm margins at the superior margin. She then underwent re-excision of superior and medial margins to ensure at least a 1 cm margin. Biopsy tract was not excised at initial or re-excision surgery. Approximately 6 weeks after completion lumpectomy, the patient noted a new palpable mass near the previous biopsy site and underwent punch biopsy. Final pathology of this new mass was concordant with early recurrence. The patient then underwent lumpectomy of the new mass along with excision of the overlying skin and biopsy tract with >1 cm margins.
Topics: Female; Humans; Phyllodes Tumor; Breast; Mastectomy, Segmental; Image-Guided Biopsy; Retrospective Studies; Chronic Disease; Breast Neoplasms; Neoplasm Recurrence, Local
PubMed: 38508594
DOI: 10.1136/bcr-2023-258352 -
Journal of Surgical Case Reports May 2024Giant phyllodes tumors, typically exceeding 10 cm in size, are neoplastic lesions with malignant potential. Surgical excision in small-breasted Asian women presents...
Giant phyllodes tumors, typically exceeding 10 cm in size, are neoplastic lesions with malignant potential. Surgical excision in small-breasted Asian women presents unique challenges where expected poor aesthetic outcomes may delay timely medical intervention. The periareolar mastopexy technique offers a comprehensive solution, enabling complete tumor removal alongside mastopexy to achieve optimal breast contouring. This approach consistently delivers favorable aesthetic outcomes, enhancing symmetry and contour. Additionally, the periareolar approach minimizes visible scarring, thereby enhancing patient satisfaction with the cosmetic outcome. Herein, we present a case report of Asian women with giant phyllodes tumors exceeding 10 cm, successfully managed using the periareolar mastopexy technique, emphasizing the importance of optimizing aesthetic outcomes in these challenging cases.
PubMed: 38812579
DOI: 10.1093/jscr/rjae342