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LETTER TO EDITOR Table of Contents   
Year : 2009  |  Volume : 52  |  Issue : 1  |  Page : 129-130
Primary mesenchymal chondrosarcoma of the breast


1 Department of Pathology, Apollo Hospitals, Hyderabad, India
2 Department of Oncology, Apollo Hospitals, Hyderabad, India

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How to cite this article:
Padua MD, Bhandari T. Primary mesenchymal chondrosarcoma of the breast. Indian J Pathol Microbiol 2009;52:129-30

How to cite this URL:
Padua MD, Bhandari T. Primary mesenchymal chondrosarcoma of the breast. Indian J Pathol Microbiol [serial online] 2009 [cited 2020 Aug 3];52:129-30. Available from: http://www.ijpmonline.org/text.asp?2009/52/1/129/44979


Sir,

Pure sarcomas of the breast are extremely rare tumors, accounting for about 0.5% of all breast tumors. Primary chondrosarcomas represent even rarer tumors. So far, only 9 cases have been reported. [1],[2],[3],[4],[5] We report another case of primary chondrosarcoma of the breast.

A 56-year-old female presented with a lump in the breast that had been gradually increasing in size over the past 1 year. Fine needle aspiration cytology (FNAC)done elsewhere was reported as malignant phylloides. On local examination, a well-defined lump in the right breast occupying the entire breast was present that measured 20x20 cms. The left breast was unremarkable. There were no palpable axillary or supraclavicular lymph nodes. A mastectomy of the right breast with axillary nodal sampling was done with an excision of the superficial aspect of pectoralis major.

On gross examination, sectioning revealed a large, grey-white tumor measuring 18x16x13 cms [Figure 1]. [6] Lymph nodes were identified in axillary sampling.

A microscopy revealed neoplastic tissue composed of sheets of neoplastic cells with round to oval nuclei, coarse chromatin and scanty cytoplasm. Numerous mitotic figures were present along with foci of necrosis. There was no evidence of ductal differentiation. Few chondroid foci were noted. A sharp interface between chondroid foci and undifferentiated areas was noted [Figure 2]. On immunohistochemistry, the cells were positive for vimentin. Positivity for S-100 was noted in chondroid as well as in the undifferentiated areas [Figure 3]. Cytokeratin, smooth muscle actin and leucocyte common antigen (LCA) were negative. The features were that of mesenchymal chondrosarcoma.

Primary sarcomas of the breast are rare tumors; the most common are angiosarcoma, followed by liposarcoma and osteosarcoma. The differentiation of chondrosarcoma from malignant phylloides with chondrosarcomatous areas can be difficult [6] . Extensive sampling to exclude any ductal elements is necessary before labelling the tumor as a primary chondrosarcoma. Metaplastic carcinoma with chondrosarcomatous areas is the other important differential diagnosis. Again, extensive sampling of the tumor along with immunohistochemistry for epithelial markers will help in its exclusion.

Surgery remains the mainstay of treatment. The role of chemotherapy and radiotherapy is not yet established because of the limited number of cases reported so far. Our patient underwent a mastectomy with axillary sampling with subsequent local radiotherapy.

To conclude, primary chondrosarcoma of the breast are rare tumors which must be considered in the differential diagnosis of tumors of the breast in chondrosarcomatous areas.

 
   References Top

1.Gupta S, Gupta V, Aggarwal PN, Kant R, Dass PM, Khurana N, et al . Primary chondrosarcoma of the breast. J Indian Med Assoc 2006;104:99-100.  Back to cited text no. 1  [PUBMED]  
2.Rao L, Kudva R, Rao RV, Kumar B. Extraskeletal myxoid chondrosarcoma of the chest wall masquerading as a breast tumor: A case report. Acta Cytol 2002;46:417-21.   Back to cited text no. 2  [PUBMED]  
3.Gupta S, Gupta V, Aggarwal PN, Kant R, Khurana N, Mandal AK. Primary chondrosarcoma of the breast: A case report. Indian J Cancer 2003;40:77-9.  Back to cited text no. 3  [PUBMED]  Medknow Journal
4.Thilagavath G, Subramanian S, Samuel AV, Rani U, Somasundaram C. Primary chondrosarcoma of the breast. J Indian Med Assoc 1992;90:16-7.  Back to cited text no. 4    
5.Beltaos E, Banerjee TK. Chondrosarcoma of the breast: Report of two cases. Am J Clin Pathol 1979;71:345-9.   Back to cited text no. 5  [PUBMED]  
6.Vera-Sempere F, Garcνa-Martνnez A. Malignant phyllodes tumor of the breast with predominant chondrosarcomatous differentiation. Pathol Res Pract 2003;199:841-5.   Back to cited text no. 6    

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Correspondence Address:
Michelle De Padua
Department of Pathology, Apollo Hospitals, Jubilee Hills, Hyderabad-500 033
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0377-4929.44979

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    Figures

  [Figure 1], [Figure 2], [Figure 3]

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