Lumbosacral osteosarcoma with dural spread, skip lesions and intravascular extension: A case report

Primary osteosarcoma of the spine is indeed rare and onlyseveral sporadic cases have been reported. It tends to occurin a slightly older age group than those with appendicularskeleton tumours. We present here an unusual case ofaggressive lumbosacral osteosarcoma in a young teenagercomplicated by extensive dural spread, skip lesions andintravascular extension. Although a histopathologicalexamination is mandatory to establish the diagnosis, thiscase emphasises the need of imaging to ascertain the fullextent of disease spread especially in deciding the type oftreatment to be instituted and to evaluate the response tothe treatment.

Primary Osteosarcoma of the Breast.

Primary osteosarcoma of the breast is an extremely rare and aggressive tumor representing 12.5% of mammary sarcomas. It is associated with early recurrence and hematogenous rather than lymphatic spread, most commonly to the lungs. We report a case of 55 year old lady with gradually increasing painless lump measuring 7 × 6 cm in upper outer quadrant of left breast of 2 months duration. FNAC smears revealed pleomorphic spindle cells admixed with osteoid and chondroid material. A differential diagnosis of metaplastic carcinoma and malignant phyllodes tumor was offered. Histopathology of the modified radical mastectomy specimen showed predominantly osteosarcomatous areas. Epithelial component was not seen even after extensive sampling of the tumor. On immunohistochemistry, vimentin, S100 and CD68 were positive while AE1/AE3, CAM5.2, ER, PR, Her2-neu and desmin were negative confirming a diagnosis of osteosarcoma. Primary osteosarcoma of breast must be differentiated from metaplastic carcinoma and malignant phyllodes tumor because of different biological behaviour and treatment approach. Immunohistochemistry plays a pivotal role in the diagnosis of this tumor.

Primary Osteosarcoma of the Breast: A case report

We report a case of primary osteosarcoma of the breast which is rare and exhibits poor prognosis. A 52 years-old-woman was admitted with rapidly growing right mammary mass. A huge lobulated dense mass with speckled calcifications, suggesting malignancy, was observed on mammography. She underwent a radical mastectomy. Grossly, the mass measured 16 14 6 cm and showed grayish white hard lobulated tissue with focal hemorrhage and necrosis. Light microscopically, the tumor was confirmed as an osteosarcoma devoid of any epithelial components. In postoperative whole body bone scan, there was no evidence of the other malignancy. To the best of our knowledge, the present case is the first report of primary osteosarcoma of the breast in Korea.

Primary Osteosarcoma of the Breast: A case report

Primary osteosarcoma of the breast is very rare. There have been no previously reported cases in Korea. In this paper, a case of primary osteosarcoma of the breast is reported. It should be distinguished from a carcinoma with extensive osseous metaplasia. Immunohistochemical and ultrastructural studies proved that the lesion, in the absence of epithelial differentiation, was a primary osteosarcoma of the breast rather than a carcinoma with extensive osseous metaplasia. Diagnostic aspects and treatment are discussed and a literature review is given.