Low Grade Myofibroblastic Sarcoma of the Breast: Case Report and Review of the Literature


  • Herbert Félix Costa
  • Adriane Mary Pereira Pimentel
  • Helen Melo Oliveira
  • Francisco Hélio Oliveira Júnior
  • João Kennedy Teixeira Lima
  • Francisco Julimar Correia de Menezes
  • Bruno Moreira Mapurunga
  • Bruno Almeida Lessa Castro
  • Luiz Carlos de Abreu
  • João Antonio Corrêa




Myofibroblastic sarcoma, breast, myofibroblasts.


Background: Myofibroblastic sarcomas of the breast are rare neoplasms, with aggressive behavior, wich mainly affects individuals 46-81 years old, predominantly females. They are malignant tumors composed of myofibroblasts, cells with an important role in inflammatory processes.

Methods and Findings:  This study, which was performed at the Hospital Geral Waldemar de Alcântara (Waldemar de Alcântara General Hospital) of the city of Fortaleza / Ceará / Brazil, reports a case of myofibroblastic sarcoma of the breast and conducts a literature review on the subject. It is about a female patient, 51, who presented, on the left breast, a mass of rapid growth, which reached about 20 cm (7,9 inches). The diagnosis was confirmed by histology and immunohistochemistry of material obtained by incisional biopsy of the lesion, showing up non-metastatic myofibrosarcoma of the breast. The treatment was simple left mastectomy and adjuvant radiotherapy, with follow-up every six months. Since this type of cancer is rare, treatment is not well established, so more studies are needed on this subject.

Conclusion: The current consensus is the complete excision of the lesion; adjuvant radiotherapy and chemotherapy may be performed. This is one of the few cases of mammary myofibrosarcoma reported in the literature and contributes to the recognition of this rare type of tumor. 


GABBIANI G, RYAN GB, MAJNO G:: Presence of modified fibroblasts in granulation tissue and their possible role in wound contractions. Experimentia 27:549-550, 1971.

TREMBLAY, G. Stromal aspects of breast carcinoma. Exp. Mol. Pathol., v 31, p248-260, 1979.

SKALLI O, SCHÃœRCH W, SEEMAYER T, LAGACE R, MONTANDON D, PITTET B,GABBIANI G: Myofibroblasts from diverse pathologic settings are heterogeneous in their content of actin isoforms and intermediate filament proteins. Lab Invest 60:275-285, 1989.

TOMASEK, J. J.; GABBIANI, G.; LINS, B.; CHAPONNIER, C.; BROWN, R.: Myofibroblast and mechanoregulation of connective tissue remodeling. Nature Rev. Mol. Cell. Biol., v 3, p 349-363, 2002.

LOPES, L.A. Análise in vitro da Proliferação Celular de Fibroblastos de Gengiva Humana Tratados com Laser de Baixa Potência. Dissertação apresentada ao Instituto de Pesquisa e Desenvolvimento da Universidade Vale do Paraíba como parte dos requisitos para obtenção do título de Mestre em Ciências, do Curso de Pós-Gradução em Engenharia Biomédica. Orientador:Prof. Dr. Renato Amaro Zíngaro Co-orientador:Prof. Dr. João GuidugliNeto,São José dos Campos, SP, 1999.

FUCHS, E. CLEVELAND, D.W.A structural scaffolding of intermediate filamentsin health and disease. Science, v 279, p 514-519, 1998.

MERMALL V.; POST, P.L.; MOOSEKER, M.S. Unconventional myosins in cell movement, membrane traffic, and signal transduction. Science; v 279, p 527-533, 1998.

POWELL, D. W.; MIFFLIN, R. C.; VALENTICH, J. D.; CROWE, S. E.; SAADA, J. I.; WEST, A . B. Myofibroblasts. Paracrine cells important in health and disease. Am. J. Physiol., v 277: 1-19, 1999.

SCHMITT-GRAFF, A.; DESMOULIERE, A.; GABBIANI, G.. Heterogeneity of myofibroblast phenotypic features: an example of fibroblastic cell plasticity. VirchowsArch., v 425, p 3-24, 1994.

ABRAHAM C.R.; et al. El miofibroblasto, uma célula multifuncional em La Patologia Pulmonar. Rev. Inst. Nal. Enf. Resp. Mex., México, v.17, n3, p 473-479, 2004.

FREITAS, L. A. R. Fibrogênese e diferenciação celular (Estudo histológico, ultraestrutural e imuno-citoquímico com o modelo do bolsão inflamatório de Selye, em ratos). 1988. 162 f. Mestrado (Dissertação em Patologia Humana)- Universidade Federal da Bahia, Salvador.

GHADIALLY, F. N.; McNAUGHTON, J. D.; LALONDE, J. M. Myofibroblastoma: a tumor of myofibroblasts. J. Submicrosc. Cytol., v15, p 1055-1063, 1983.

SEEMAYER, T. A.; LAGACÈ, R.; SCHÜRCH, W l.On the sclerosis and nodularity in nodular sclerosing Hodgkin’s disease. Virchows Arch., v 385,p 283-291, 1980.

SCHÃœRCH, W.; SKALLI, O.; SEEMAYER, T.A.; GABBIANI, G. IntermediateFilament Proteins and Actin Isoforms as Markers for Soft Tissue TumorDifferentiation and Origin. Am. J. Pathol., v 128, p 91-103, 1987.

GHADIALLY FN. Diagnostic Electron Microscopy of Tumours. London: Butterworths; 136, 1980.

STILLER D, KATENKAMP D. Cellular features in desmoids fibromatosis and

well-differentiated fibrosarcomas: an electron microscopic study. Virchows Arch

A Pathol Anat Histol. 369:155-164, 1975.

VASUDEV KS, HARRIS M.A sarcoma of myofibroblasts. An ultrastructural study. Arch Pathol Lab Med. 102:185-188, 1978.

D'ANDIRAN G, GABBIANI G. A metastasizing sarcoma of the pleura composedofmyofibroblasts. Prog Surg Pathol. 2:31-40, 1980.

EYDEN BP, CHRISTENSEN L, TAGORE V, et al. Myofibrosarcoma of subcutaneous soft tissue of the cheek. J Submicrosc Cytol Pathol; 24:307-313, 1972.

TACCAGNI G, ROVERE E, MASULLO M, et al. Myofibrosarcoma of the breast: review of the literature on myofibroblastic tumors and criteria for defining

myofibroblastic differentiation. Am J Surg Pathol. 21:489-496, 1997.

SMITH DM, MAHMOUD HH, JENKINS JJ 3RD, et al. Myofibrosarcoma of the head andneck in children. Pediatr Pathol Lab Med. 15:403-418, 1995.

EYDEN BP, BANERJEE SS, HARRIS M, et al. A study of spindle cell sarcomas showing myofibroblastic differentiation. Ultrastruct Pathol. 15:367-378, 1991.

FISHER C. The value of electronmicroscopy and immunohistochemistry in the

diagnosis of soft tissue sarcomas: a study of 200 cases. Histopathology.

:441-454, 1990.

MORGAN PB, CHUNDRU S, HATCH SS, HAWKINS HK, ADEGBOYEGA PA, AND ELTORKY MA. Low-Grade Myofibroblastic Sarcoma of the Breast. Journal of Clinical Oncology. 25: 6249, 2005.

MENTZEL T, DRY S, KATENKAMP D, et al. Low-grade myofibroblastic sarcoma: analysis of 18 cases in the spectrum of myofibroblastic tumors. Am J Surg

Pathol. 22:1228-1238, 1998.

MONTGOMERY E, GOLDBLUM JR, FISHER C. Myofibrosarcoma: a clinic pathologicstudy. Am J Surg Pathol. 25:219-228, 2001.

KUHNEN C, HOMANN HH, MENTZEL T. [Myofibroblastic sarcoma of the thoracicwall. Change in appearance in tumour recurrence]. Pathologe. 24:128-135, 2003.

FISHER C, GOLDBLUM JR, MONTGOMERY E. Calponin and h-caldesmon in sarcomas ofmyofibroblasts. Mod Pathol. 16:11A, 2003.

EYDEN BP, CHRISTENSEN L. Leiomyosarcoma versus myofibrosarcoma: observationsand terminology. Ultrastruct Pathol. 17:231-239, 1993.

FISHER C. Myofibroblastic Malignancies. Advances in Anatomic Pathology. 190-201, 2004.

STARK M, HOFFMANN A, XIONG Z. Mammary Myofibrosarcoma: Case Report and Literature Review. The breast Journal. 3: 300-304, 2011.

TACCAGNI G, ROVERE E, MASULLO M, et al: Myofibrosarcoma of the breast: Review of the literature on myofibroblastic tumors and criteria fordefining myofibroblastic differentiation. Am J Surg Pathol 21:489-496, 1997.







Most read articles by the same author(s)

1 2 3 4 > >>