RESUMO
A 70-year-old woman visited a local hospital complaining of a nodulein the right breast, present since 1 month. She was referred to our hospital for further evaluation. Following mammotome (MMT) biopsy, the nodule was diagnosed as myxoid/round cell liposarcoma. She underwent total mastectomy of the right breast. Histological analysis indicated that the tumor was almost entirely composed of proliferating small round mesenchymal cells in amyxoid matrix background with capillary-like vessels with partial necrosis (<10%). Immunohistochemically, p53 positive cells were seen focally (<1%) only, and the Ki-67 labeling index was approximately 20%. Since the surgical margin was histologically positive despite pathologic findings of high-grade malignancy, adjuvant treatment involving local radiation therapy (60Gy) was administered. The patient was free from any symptoms of local recurrence and metastases 1 year and 8 months after surgery.
Assuntos
Neoplasias da Mama/patologia , Lipossarcoma Mixoide/patologia , Idoso , Biomarcadores Tumorais/análise , Biomarcadores Tumorais/genética , Biópsia , Neoplasias da Mama/química , Neoplasias da Mama/genética , Neoplasias da Mama/cirurgia , Feminino , Humanos , Imuno-Histoquímica , Antígeno Ki-67/análise , Lipossarcoma Mixoide/química , Lipossarcoma Mixoide/genética , Lipossarcoma Mixoide/cirurgia , Imageamento por Ressonância Magnética , Mastectomia , Neoplasia Residual , Valor Preditivo dos Testes , Radioterapia Adjuvante , Resultado do Tratamento , Proteína Supressora de Tumor p53/análise , Ultrassonografia MamáriaRESUMO
A 36-year-old woman presented with a 10 mm diameter mass in the right breast. Since the mass persisted for 3 months after detection and mammary carcinoma was suspected based on ultrasonographic findings, the mass was resected. Histologically, the mass demonstrated proliferative margins and consisted of spindle cells with bland cytologic features and abundant collagen. Immunohistochemically, the spindle cells were positive for vimentin and smooth muscle actin, and were negative for cytokeratins and desmin. Furthermore, the cells showed MIB-1 immunoreactivity with a MIB-1 labeling index of 4.1. Based on these findings, was diagnosed fibromatosis. Breast fibromatosis is rare and is usually misdiagnosed as breast carcinoma preoperatively. To date, only 10 cases of breast fibromatosis have been reported in Japan. Among the reported cases in Japan, our patient presented with the smallest mass, and ultrasonographic findings in this case were the same as those of other cases. Our experience and a review of the literature indicated that differentiation of fibromatosis from carcinoma is very difficult by ultrasonographic examination. In our case, despite involvement of the surgical margins, there was no recurrence. This may be attributed to the small size of the mass and focal exposure.
