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Breast Metastasis of Extraskeletal Myxoid Chondrosarcoma: A Case Report.

Lubana SS, Bashir T, Tuli SS, Kemeny MM, Heimann DM - Am J Case Rep (2015)

Bottom Line: The mass was fully resected with left below-knee amputation.A follow-up CT showed a new right breast nodule along with metastases to lung and bones.The results of the core needle biopsies of the right breast masses seen on mammogram were morphologically identical to extraskeletal myxoid chondrosarcoma.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Icahn School of Medicine at Mount Sinai, Queens Hospital Center, Queens, NY, USA.

ABSTRACT

Background: Extraskeletal myxoid chondrosarcoma is a unique and distinct clinicopathological entity in terms of its origin, morphology, and biologic behavior. Despite being a slow-growing tumor, it has a high rate of local recurrences and history of metastases to uncommon sites like the mandible, liver, retroperitoneum, right ventricle, pancreas, and central nervous system. Here, we report a very unique case of extraskeletal myxoid chondrosarcoma that metastasized to the breast, which itself is a very rare site for metastases.

Case report: A 58-year-old woman presented with a large, firm, and tender soft-tissue mass (6.0×7.0 cm) underneath the sole of the left foot. A computerized tomography (CT) scan showed a heterogeneous lobulated mass in the plantar aspect of the forefoot, measuring 8.6×8.0×7.1 cm. Punch biopsies revealed histology consistent with extraskeletal myxoid chondrosarcoma. Metastatic work-up was negative. The mass was fully resected with left below-knee amputation. The histology of the resected mass was consistent with extraskeletal myxoid chondrosarcoma. A follow-up CT showed a new right breast nodule along with metastases to lung and bones. The results of the core needle biopsies of the right breast masses seen on mammogram were morphologically identical to extraskeletal myxoid chondrosarcoma.

Conclusions: Although rare, metastases to the breast should be considered in the differential diagnosis of a breast mass. A close long-term follow-up is needed due to the unpredictable behavior of extraskeletal myxoid chondrosarcoma and the high frequency of local recurrences, metastases, and death due to disease.

No MeSH data available.


Related in: MedlinePlus

An approximately 8-cm heterogeneously enhancing, hypodense, mass in the plantar aspect of the forefoot. Flexor digitorum tendon (purple arrow) is encased in the mass.
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f2-amjcaserep-16-406: An approximately 8-cm heterogeneously enhancing, hypodense, mass in the plantar aspect of the forefoot. Flexor digitorum tendon (purple arrow) is encased in the mass.

Mentions: A 58-year-old Jamaican woman presented at our hospital with complaints of a growth underneath the sole of her left foot for 1 year, with worsening pain. Physical examination showed a large 6.0×7.0 cm soft-tissue mass with areas of maceration (Figure 1). The mass was firm and tender on palpation. There was no active bleeding or discharge. A computerized tomography (CT) scan of the left lower extremity showed a lobulated low-attenuation soft-tissue mass on the plantar aspect of the forefoot, measuring 8.6×8.0×7.1 cm (Figure 2). Multiple punch biopsies of the mass revealed monomorphic round tumor cells with minimal cytoplasm in the loose myxoid background, consistent with extraskeletal myxoid chondrosarcoma (EMC) (Figure 3 [A – 100×, B – 400×]). The immunohistochemical stain was positive for synaptophysin (Figure 4A) and weakly positive for S 100 (Figure 4B). To confirm the diagnosis, a specimen was sent to the Mayo Clinic Medical Laboratories for molecular testing.


Breast Metastasis of Extraskeletal Myxoid Chondrosarcoma: A Case Report.

Lubana SS, Bashir T, Tuli SS, Kemeny MM, Heimann DM - Am J Case Rep (2015)

An approximately 8-cm heterogeneously enhancing, hypodense, mass in the plantar aspect of the forefoot. Flexor digitorum tendon (purple arrow) is encased in the mass.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4492482&req=5

f2-amjcaserep-16-406: An approximately 8-cm heterogeneously enhancing, hypodense, mass in the plantar aspect of the forefoot. Flexor digitorum tendon (purple arrow) is encased in the mass.
Mentions: A 58-year-old Jamaican woman presented at our hospital with complaints of a growth underneath the sole of her left foot for 1 year, with worsening pain. Physical examination showed a large 6.0×7.0 cm soft-tissue mass with areas of maceration (Figure 1). The mass was firm and tender on palpation. There was no active bleeding or discharge. A computerized tomography (CT) scan of the left lower extremity showed a lobulated low-attenuation soft-tissue mass on the plantar aspect of the forefoot, measuring 8.6×8.0×7.1 cm (Figure 2). Multiple punch biopsies of the mass revealed monomorphic round tumor cells with minimal cytoplasm in the loose myxoid background, consistent with extraskeletal myxoid chondrosarcoma (EMC) (Figure 3 [A – 100×, B – 400×]). The immunohistochemical stain was positive for synaptophysin (Figure 4A) and weakly positive for S 100 (Figure 4B). To confirm the diagnosis, a specimen was sent to the Mayo Clinic Medical Laboratories for molecular testing.

Bottom Line: The mass was fully resected with left below-knee amputation.A follow-up CT showed a new right breast nodule along with metastases to lung and bones.The results of the core needle biopsies of the right breast masses seen on mammogram were morphologically identical to extraskeletal myxoid chondrosarcoma.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Icahn School of Medicine at Mount Sinai, Queens Hospital Center, Queens, NY, USA.

ABSTRACT

Background: Extraskeletal myxoid chondrosarcoma is a unique and distinct clinicopathological entity in terms of its origin, morphology, and biologic behavior. Despite being a slow-growing tumor, it has a high rate of local recurrences and history of metastases to uncommon sites like the mandible, liver, retroperitoneum, right ventricle, pancreas, and central nervous system. Here, we report a very unique case of extraskeletal myxoid chondrosarcoma that metastasized to the breast, which itself is a very rare site for metastases.

Case report: A 58-year-old woman presented with a large, firm, and tender soft-tissue mass (6.0×7.0 cm) underneath the sole of the left foot. A computerized tomography (CT) scan showed a heterogeneous lobulated mass in the plantar aspect of the forefoot, measuring 8.6×8.0×7.1 cm. Punch biopsies revealed histology consistent with extraskeletal myxoid chondrosarcoma. Metastatic work-up was negative. The mass was fully resected with left below-knee amputation. The histology of the resected mass was consistent with extraskeletal myxoid chondrosarcoma. A follow-up CT showed a new right breast nodule along with metastases to lung and bones. The results of the core needle biopsies of the right breast masses seen on mammogram were morphologically identical to extraskeletal myxoid chondrosarcoma.

Conclusions: Although rare, metastases to the breast should be considered in the differential diagnosis of a breast mass. A close long-term follow-up is needed due to the unpredictable behavior of extraskeletal myxoid chondrosarcoma and the high frequency of local recurrences, metastases, and death due to disease.

No MeSH data available.


Related in: MedlinePlus