Periductal Stromal Sarcoma of the Breast: A Case Report
Introduction: Periductal Stromal Sarcoma (PSS), especially spindle and epithelioid types, is a rare subtype of the malignant fibroepithelial tumor with benign ductal elements and a sarcomatous stroma composed of spindle cells. The therapeutic management of PSS is based on wide surgery with free margins, and adjuvant therapies are not required.
Case Presentation: This report describes a 37-year-old woman who presented to Shariati hospital with a right breast mass for review and a second opinion pathology report. The patient had undergone a radical mastectomy in another hospital three months previously. Histological and immunohistochemical examinations revealed PSS and all dissected lymph nodes were free of tumor. Based on the diagnosis, the patient received no adjuvant treatment (such as chemotherapy or radiotherapy). After nine months of close follow-up examinations, no recurrence was observed.
Conclusion: PSS is an extremely rare disease with low-grade sarcomatous behavior, which may evolve into a phyllodes tumor or an entity of breast cancer. Therefore, frequent follow-up examinations are required.
 Wiseman BS, Werb Z. Stromal effects on mammary gland development and breast cancer. Science. 2002; 296(5570):1046-9. [DOI:10.1126/science.1067431] [PMID] [PMCID]
 Rao AC, Geetha V, Khurana A. Periductal stromal sarcoma of breast with lipoblast-like cells: A case report with review of literature. Indian Journal of Pathology and Microbiology. 2008; 51(2):252-4. [DOI:10.4103/0377-4929.41673] [PMID]
 Burga AM, Tavassoli FA. Periductal stromal tumor: A rare lesion with low-grade sarcomatous behavior. The American Journal of Surgical Pathology. 2003; 27(3):343-8. [DOI:10.1097/00000478- 200303000-00007] [PMID]
 Leibl S, Moinfar F. Mammary NOS-type sarcoma with CD10 expression: A rare entity with features of myoepithelial differentiation. The American Journal of Surgical Pathology. 2006; 30(4):450-6. [DOI:10.1097/00000478-200604000-00004] [PMID]
 Abbasi SL, McNamara K, Absar MS, Darlington A, Clucas F, Titi S. Periductal stromal tumor of breast: A case report and a review of literature. The Korean Journal of Pathology. 2014; 48(6):442-4. [DOI:10.4132/KoreanJPathol.2014.48.6.442] [PMID] [PMCID]
 Masbah O, Lalya I, Mellas N, Bekkouch I, Allaoui M, Hassouni K, et al. Periductal stromal sarcoma in a child: A case report. Journal of Medical Case Reports. 2011; 5(249):1-3. [DOI:10.1186/1752-1947- 5-249] [PMID] [PMCID]
 Bousquet G, Confavreux C, Magné N, de Lara CT, Poortmans P, Senkus E, et al. Outcome and prognostic factors in breast sarcoma: A multicenter study from the rare cancer network. Radiotherapy and Oncology. 2007; 85(3):355-61. [DOI:10.1016/j.radonc.2007.10.015] [PMID]
 Pandey M, Mathew A, Abraham EK, Rajan B. Primary sarcoma of the breast. Journal of Surgical Oncology. 2004; 87(3):121-5. [DOI:10.1002/jso.20110] [PMID]
 Al-Benna S, Poggemann K, Steinau HU, Steinstraesser L. Diagnosis and management of primary breast sarcoma. Breast Cancer Research and Treatment. 2010; 122(3):619-26. [DOI:10.1007/s10549- 010-0915-y] [PMID]
 Tomas D, Janković D, Marusić Z, Franceschi A, Mijić A, Krušlin B. Low-grade periductal stromal sarcoma of the breast with myxoid features: Immunohistochemistry. Pathology International. 2009; 59(8):588-91. [DOI:10.1111/j.1440-1827.2009.02411.x] [PMID]
 Callery CD, Rosen PP, Kinne DW. Sarcoma of the breast. A study of 32 patients with reappraisal of classification and therapy. Annals of Surgery. 1985; 201(4):527-32. [DOI:10.1097/00000658- 198504000-00020] [PMID] [PMCID]
 Pollard SG, Marks PV, Temple LN, Thompson HH. Breast sarcoma. A clinicopathologic review of 25 cases. Cancer. 1990; 66(5):941-4. [DOI:10.1002/1097-0142(19900901)66:5<941::aidcncr2820660522>3.0.co;2-b] [PMID]
 Lan Y, Zhu J, Liu J, Yang H, Jiang Y, Wei W. Periductal stromal sarcoma of the breast: A case report and review of the literature. Oncology Letters. 2014; 8(3):1181-3. [DOI:10.3892/ol.2014.2294] [PMID] [PMCID]
 Blanchard DK, Reynolds CA, Grant CS, Donohue JH. Primary nonphylloides breast sarcomas. The American Journal of Surgery. 2003; 186(4):359-61. [DOI:10.1016/S0002-9610(03)00269-1]
 Norris HJ, Taylor HB. Sarcomas and related mesenchymal tumors of the breast. Cancer. 1968; 22(1):22-8. [DOI:10.1002/1097- 0142(196807)22:1<22::aid-cncr2820220105>3.0.co;2-r] [PMID]
 Hart WR, Bauer RC, Oberman HA. Cystosarcoma phyllodes: A clinicopathologic study of twenty-six hypercellular periductal stromal tumors of the breast. American Journal of Clinical Pathology. 1978; 70(2):211-6. [DOI:10.1093/ajcp/70.2.211] [PMID]
|Issue||Vol 6 No 2 (2021): Mar/Apr|
|Sarcoma Breast Adjuvant therapy|
|Rights and permissions|
|This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.|