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Breast malignant, males, children

Sarcoma

Liposarcoma


Reviewer: Monika Roychowdhury, M.D. (see Reviewers page)
Revised: 7 November 2012, last major update October 2012
Copyright: (c) 2001-2012, PathologyOutlines.com, Inc.

Definition
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● Malignant tumor containing at least a few lipoblasts

Epidemiology
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● Rare, 100 cases reported through 2002
● 0.3% of all breast sarcomas, themselves only 1% of all breast malignancies
● Median age 47 years, range 19-76 years

Clinical
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● May be associated with radiation therapy
● Slow growing, painful breast mass, usually unilateral
● Axillary nodal metastases are rare, skin changes unusual
● Usually myxoid or pleomorphic subtype

Treatment and prognosis
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● Particularly aggressive when associated with pregnancy
● Death, when it occurs, is usually within 18 months of diagnosis
● Treatment is wide excision, axillary dissection not needed (Hum Pathol 1986;17:906)

Case reports
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● 19 year old woman with pleomorphic liposarcoma mimicking abscess (Breast J 2010;16:537)
● 25 year old woman with myxoid liposarcoma diagnosed as fibroadenoma on FNA (Diagn Cytopathol 2008;36:674)
● 42 year old woman (JBR-BTR 2010;93:299)
● 47 year old woman with primary pleomorphic liposarcoma (Indian J Pathol Microbiol 2011;54:124)
● 75 year old woman (Arch Pathol Lab Med 2001;125:1503)

Gross description
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● Median 8 cm, well circumscribed, gelatinous to firm with yellow/tan cut surface; larger tumors may be necrotic

Gross images
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Circumscribed tumors

Micro description
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● Similar to soft tissue tumors
● Depending on subtype: mixture of pleomorphic bizarre giant cells, myxoid stroma, mature adipose cells, inflammatory cells, lipoblasts (scalloped, irregular, hyperchromatic nuclei and sharply defined intracytoplasmic vacuoles containing lipid) and capillaries
● Margins are usually at least focally infiltrative

Micro images
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Myxoid liposarcoma


Well differentiated liposarcoma

   
Lipoblast with vacuolated cytoplasm


Well circumscribed tumor (AFIP)

Positive stains
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● S100 (lipoblasts)

Differential diagnosis
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Adenolipoma: lipoma with eccrine sweat glands or other epithelial elements
Angiolipoma: prominent capillaries with hyaline thrombi; no atypia, no lipoblasts
Fibroadenoma with fat: no atypia, no lipoblasts
Lipoma: no atypia, no lipoblasts
Malignant phyllodes tumor with focal liposarcomatous differentiation: has distinctive phyllodes component
Pleomorphic lipoma: prominent floret cells, no atypia, no lipoblasts
Silicone implants: silicone is refractile, may have granulomas that resemble lipoblasts

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


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