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Breast malignant, males, children

Sarcoma

Stromal sarcoma


Reviewer: Monika Roychowdhury, M.D., (see Reviewers page)
Revised: 21 November 2012, last major update August 2012
Copyright: (c) 2001-2012, PathologyOutlines.com, Inc.

General
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● Rare lesion with sarcomatous stroma, benign ductal elements, no phyllodes architecture (Am J Surg Pathol 2003;27:343)

Terminology
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● Also called periductal stromal sarcoma

Epidemiology
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● Mean age 55 years, range 37-89 years

Treatment and prognosis
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● Excision with negative margin
● May recur

Case reports
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● 14 year old boy (J Med Case Rep 2011;5:249)
● 29 year old woman (Surg Today 2011;41:1145)
● 47 year old woman with primary stromal sarcoma of the breast with MFH like features (Diagn Cytopathol 2011;39:223)
● 52 year old woman whose tumor had myxoid features (Pathol Int 2009;59:588)
● Tumor involving entire breast with axillary nodal metastases (Asian J Surg 2004;27:339)
● Two cases (Gan To Kagaku Ryoho 2011;38:2171)

Gross description
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● Mean 3 cm, solid, gray-white, homogenous

Micro description
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● Circumferential cuffs of predominantly uniform plump spindle cells with variable cellularity and atypia surrounding open tubules and ducts, but no phyllodes pattern
● May have multiple nodules separated by adipose tissue
● >3 stromal mitotic figures per 10 HPF
● Stromal infiltration into adjacent breast tissue
● May have osseous metaplasia or resemble fibrosarcoma
Periductal stromal hyperplasia if no/minimal atypia and 0-2 stromal mitotic figures/10 HPF

Micro images
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14 year old boy

Positive stains
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● CD34
● Variable CD117

Negative stains
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● ER, PR, myoepithelial markers

Electron microscopy descriptions
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● Immature cells with abundant free ribosomes, profiles of rough ER, variable microfilaments
● Often prominent cell nesting and a variety of cell junctions, including desmosomes (Cancer 1979;43:209)

End of Breast malignant, males, children > Sarcoma > Stromal sarcoma


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