Breast malignant, males, children

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Breast malignant, males, children

Sarcoma

Osteosarcoma

Reviewer: Monika Roychowdhury, M.D. (see Reviewers page)
Revised: 13 November 2012, last major update November 2012
Copyright: (c) 2001-2012, PathologyOutlines.com, Inc.

Definition
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● Malignant tumor of osteoid producing spindle cells

Epidemiology
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● Rare
● Median age 64 years, range 27-89 years

Case reports
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● 16 year old girl (J Pediatr Hematol Oncol 2012;34:e261)
● 40 year old woman (World J Surg Oncol 2006;4:90)
● 49 year old woman (APMIS 2006;114:581)
● 59 year old woman (Pathol Int 2009;59:111)
● 88 and 96 year old women (Arch Pathol Lab Med 2007;131:792)

Treatment and prognosis
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● Total excision without axillary dissection (Am J Surg Pathol 1998;22:925)
● Local recurrence, metastases and death from disease are common

Gross description
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● Mean 5 cm (1-13 cm)
● 60% are grossly circumscribed

Gross images
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Large, relatively well-circumscribed, necrotic tumor with cartilaginous and calcified foci (after tissue sampling)

Well circumscribed tumor with large areas of ossification (asterisks) and cystic or necrotic zones (stars)

Micro description
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● Resembles skeletal osteosarcoma, with fibroblastic, osteoclastic or osteoblastic subtypes
● By definition has spindle cells and neoplastic osteoid or bone, lacks an epithelial component and does not originate in bone
● Usually at least focally infiltrative

Micro images
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Neoplastic bone and spindle cells

Pleomorphic high-grade sarcoma with malignant osteoid (stars) and multinucleated osteoclastic giant cells (arrows)

Negative stains
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● ER, PR, HER2 (Arch Pathol Lab Med 2006;130:691)

Differential diagnosis
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● Metaplastic carcinoma: has epithelial component
● Metastases: need clinical history (Australas Radiol 1999;43:108)
● Phyllodes tumor with osteosarcomatous differentiation: phyllodes component present (J Med Case Rep 2011;5:293)

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

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