Aim: We present a case of a breast lump that threw a
histopathological surprise of liposarcoma after excision.
Background: Liposarcoma of the breast is a rare entity
accounting for 0.3% of breast sarcomas which in turn are responsible for less
than 1% of breast malignancies. We present this case for rarity and for its
being a histological surprise. Most of the liposarcomas are seen to arise in
malignant phyllodes tumors. Because of the rarity of the disease, there are no
randomized trials specifically addressing treatment modalities in breast
sarcoma.
Case Summary: We report a case of 60 60-year-old female
presenting with a painless, progressively increasing lump in the right breast
for 4 months. Examination revealed a 6*5 cm, firm, non-tender, mobile, lump
with a smooth surface and clear margins in the right upper outer quadrant.
Ultrasonography of breasts and mammography were suggestive of BIRADS III
lesion. The results of the Trucut biopsy pointed to a fibroepithelial lesion
with cellular stroma. An excision biopsy was performed, taking into account the
patient's age and the size of the lump. According to the histopathology report,
the fibro cellular stroma is where liposarcoma originates. In the second stage,
re-excision of the margins was performed as part of completion surgery. The
patient was asymptomatic with no evidence of recurrence after 1.5 years of
follow-up.
Discussion: Most of the liposarcomas have been found to
arise in malignant phyllodes tumors, as opposed to primary liposarcomas of the
breast which arise de novo from fibro cellular stroma. Our case was liposarcoma
of breast which was identified on histopathology after excisional biopsy and
was managed well with re-excision of the margins as per NCCN guidelines.
Conclusion: Liposarcoma of the breast is rare. It can
present as a benign lesion clinically. Treatment is by wide local excision with
tumour-free margins or re-resection of margins in case of a histological
surprise.
Author(s) Details
Chhabra Maninder K
Department of General Surgery, Deen Dayal Upadhyay Hospital, New Delhi,
India.
Dogra Reetu
Department of General Surgery, Deen Dayal Upadhyay Hospital, New Delhi,
India.
Sood Neelam
Department of Pathology and Lab Medicine, Deen Dayal Upadhyay Hospital, New
Delhi, India.
Chhibber Puneet
Department of General Surgery, Deen Dayal Upadhyay Hospital, New Delhi,
India.
Please see the book here:- https://doi.org/10.9734/bpi/mmrnp/v1/12705F
