extra skeletal osteosarcoma of the breast

A case of
primary extraskeletal osteosarcoma of the breast. Mammography. a At the initial visit, it revealed a 1.5-cm coarse heterogeneously high-density calcified lesion at the upper outer portion of the right breast. b About 8 months after our first medical examination, it revealed a slight enlargement of the coarse calcification. c, d About 16 months after our first medical examination, the lesion had grown to 4.5 cm, and new microcalcifications that were fine and irregular in shape and density appeared around the enlarged original coarse calcified tumor
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A case of
primary extraskeletal osteosarcoma of the breast. Ultrasonography. A 1.7-cm-diameter relatively smoothly marginated hypoechoic mass containing multiple calcifications
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A case of
primary extraskeletal osteosarcoma of the breast. Magnetic resonance imaging. a A 4.5-cm-diameter mass at the upper outer portion of the right breast. b Fat suppression (FS) T2-weighted imaging (WI): A high signal intensity at the periphery and center of the tumor. c Gadolinium (Gd) FS T1WI: A high signal intensity at the periphery of the tumor but a low signal intensity in the central area
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Primary osteosarcoma of the breast is an uncommon breast malignancy and is a sub type extraskeletal osteosarcoma.

Epidemiology

While it can present in a wide are group, the peak age at presentation is around the 6 decade.

Pathology 

The presence of bone in breast lesions is not diagnostic of osteosarcoma as osteoid tissue can be present in epithelial and mesenchymal neoplasms, both benign and malignant, such as fibroadenoma, phyllodes tumor , and metaplastic carcinomas. Therefore, a diagnosis of mammary osteosarcoma can only be established after a metaplastic carcinoma or biphasic tumor has been adequately excluded. Approximately 60% of tumors are grossly circumscribed .

Markers

Serum alkaline phosphate (ALP) levels are typically elevated.

Radiographic features

Mammography

Mammographic appearances can be variable. Most of the tumors presented as large masses with relatively well-defined margins and lobulated borders, often containing calcifications. Calcifications tend to be usually coarse (cotton wool like), dense, and sometimes similar to fibroadenomas.

Treatment and prognosis

Mammary osteosarcomas are aggressive tumors with a propensity for blood-borne rather than lymphatic spread. A total excision without an axillary dissection is usually part of standard treatment.

Siehe auch:
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Assoziationen und Differentialdiagnosen zu extraskelettales Osteosarkom der Mamma:
Mammakarzinom
 
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extraskelettales
Osteosarkom
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