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Breast malignant, males, children

Sarcoma

Leiomyosarcoma


Reviewer: Monika Roychowdhury, M.D. (see Reviewers page)
Revised: 14 October 2012, last major update October 2012
Copyright: (c) 2001-2012, PathologyOutlines.com, Inc.

Definition
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● Malignant smooth muscle tumor
● Rare in breast as primary or metastases (< 1% of all breast tumors, ~25 cases reported in English literature (J Breast Cancer 2012;15:124)

Treatment
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● Excision with negative margin
● Radiation therapy suggested for large tumors with < 3 cm margin (Breast 2011;20:389)

Case reports
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● 18 year old woman (Breast 2011;20:389)
● 48 year old woman (J Breast Cancer 2012;15:124)
● 50 year old woman with 10 year history of cyclophosphamide for SLE (Cases J 2008 Nov 7;1(1):301)
● 52 year old woman (J Zheijiang Univ Sci B 2008;9:109)
● 53 year old man with leiomyosarcoma of nipple (Am J Surg Pathol 1978;2:299)

Clinical images
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Necrotic breast mass

Gross images
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Lobulated elastic tumor

Micro description
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● Intersecting fascicles of spindle cells with moderate eosinophilic cytoplasm, cigar shaped nuclei with blunt ends, moderate nuclear atypia, frequent mitotic figures

Micro images
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Dense cellularity and intersecting fascicles

       
48 year old woman

           
Tumor of nipple-areolar complex


Nuclear pleomorphism and mitotic activity (AFIP)


Cellular pleomorphic tumor

Cytology description
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● Large, dissociated round to spindle cells, medium to large, with abundant vacuolated cytoplasm with occasional intranuclear cytoplasmic invaginations; cells have pleomorphic nuclei, prominent nucleoli
● Also mitotic figures, osteoclast-like giant cells and stromal fragments (Diagn Cytopathol 2003;29:172, Acta Cytol 2008;52:485)

Cytology images
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Various images

Positive stains
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● Actin, desmin, vimentin

Negative stains
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● Keratin, S100, CD34

Molecular / cytogenetics
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● 10q-, 13q-
● Also 17p-, 1q+, 17p+ (Cancer Genet Cytogenet 2004;149:53)

Differential diagnosis
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● Metastatic tumor (Diagn Cytopathol 2007;35:508, Ir J Med Sci 2011;180:889)

End of Breast malignant, males, children > Sarcoma > Leiomyosarcoma


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