Журнал клинических случаев

Primary Undifferentiated Pleomorphic Sarcoma of the Breast in a Male Patient: A Case Report and a Review of the Literature

Abstract

Jaba S, Belhabib S, Kebdani T, Elkacemi H, Majjaoui S and Benjaafar N

Male breast cancer is a rare disease, accounting for less than 1% of all breast cancers. Like soft tissue sarcomas, breast sarcomas are a heterogeneous group of several subtypes: osteosarcoma, liposarcoma, fibrosarcoma, leiomyosarcoma, angiosarcoma, rhabdomyosarcoma, pleomorphic sarcoma, and sarcomas of uncertain differentiation. Undifferentiated pleomorphic sarcoma constitutes less than 5% of all sarcomas in adults. It is most frequently located in the extremities but has also been reported in the retroperitoneum and the abdomen, However, Localization in the breast is extremely rare, especially in patients with no history of radiation. In this report, we describe an unusual case of undifferentiated pleomorphic sarcoma of the breast in 60-years-old men who presented a tumor measuring over 4 cm with pain in the left breast. He noticed the mass 3 months previously. Breast ultrasound revealed a left tumor. The patient underwent total mastectomy without axillary lymph node dissection. Based on examination of the excised tumor, the initial pathologic diagnosis was atypical spindle-shaped cells with uncertain malignant potential. Histological findings with immunomarkers led to the final diagnosis of undifferentiated pleomorphic sarcoma. Following the simple mastectomy, the patient was given adjuvant hypofractionated radiotherapy. The follow up at 42 months was uneventful. This case highlights a rare and interesting variant of primary breast sarcoma presenting in a male patient. A review of the available literature with evaluation of the etiology, prognostic factors and treatment modalities of pleomorphic sarcoma of the breast are discussed.