Low Grade Myofibroblastic Sarcoma of the Breast: Case Report and Review of the Literature
DOI:
https://doi.org/10.3823/1801Keywords:
Myofibroblastic sarcoma, breast, myofibroblasts.Abstract
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.Â
References
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, SCHÜRCH 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 ParaÃba como parte dos requisitos para obtenção do tÃtulo de Mestre em Ciências, do Curso de Pós-Gradução em Engenharia Biomédica. Orientador:Prof. Dr. Renato Amaro ZÃngaro 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-citoquÃmico 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.
SCHÜRCH, 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.
Downloads
Published
Issue
Section
License
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access and Benefits of Publishing Open Access).
Â
Â