24898994 Visualization

A woman Sex in her 60s Age was found to have screen Diagnostic_procedure detected invasive Detailed_description lobular Detailed_description breast Disease_disorder carcinoma Disease_disorder of the right Biological_structure breast Biological_structure and invasive Detailed_description ductal Disease_disorder carcinoma Disease_disorder , no Detailed_description special Detailed_description type Detailed_description , of the left Biological_structure breast Biological_structure .
Staging CT Diagnostic_procedure imaging Diagnostic_procedure prior to mastectomy Therapeutic_procedure showed a 12 Distance   cm Distance pelvic Biological_structure mass Sign_symptom which on initial impression was thought to be a fibroid Sign_symptom uterus Biological_structure .
Associated postmenopausal Detailed_description bleeding Sign_symptom led to pelvic Biological_structure ultrasound Diagnostic_procedure , hysteroscopy Diagnostic_procedure and biopsy Diagnostic_procedure .
The biopsy Diagnostic_procedure showed undifferentiated Detailed_description sarcoma Disease_disorder , unclassifiable Lab_value with immunohistochemistry Diagnostic_procedure .
Following discussion at a multidisciplinary team meeting it was felt that the uterine Biological_structure tumour Sign_symptom was a separate primary Detailed_description malignancy Detailed_description rather than metastasis Disease_disorder from the breast Biological_structure .
Hysterectomy Therapeutic_procedure and bilateral Detailed_description salpingo Therapeutic_procedure - oophorectomy Therapeutic_procedure was performed for both treatment purposes and to fully categorise the malignancy to guide further adjuvant Therapeutic_procedure therapy Therapeutic_procedure .
Histological Diagnostic_procedure examination Diagnostic_procedure of the resection specimen showed a partially Detailed_description necrotic Detailed_description tumour Sign_symptom with a discrete Detailed_description outline Detailed_description located within and extending throughout the myometrium Biological_structure .
The tumour Coreference was composed of malignant Detailed_description spindle Detailed_description cells Detailed_description (figure 1A), with an intermittent component of pleomorphic Detailed_description cells Detailed_description with abundant eosinophilic Detailed_description cytoplasm Detailed_description .
Plentiful Detailed_description osteoclast Detailed_description - like Detailed_description giant Sign_symptom cells Sign_symptom were present (figure 1B).
Mitoses Diagnostic_procedure were numerous Lab_value and structurally Sign_symptom abnormal Sign_symptom forms Sign_symptom were common.
Neoplastic Coreference cells Coreference were surrounded by hyaline osteoid matrix and foci of coarse neoplastic woven bone (figure 1C).
Generous sampling of the tumour showed no admixed neoplastic Sign_symptom epithelial Sign_symptom elements Sign_symptom , thus ruling out the more common carcinosarcoma ( malignant Disease_disorder mixed Disease_disorder Müllerian Disease_disorder tumour Disease_disorder ).
Tumour Coreference cells Coreference showed immunohistochemical Diagnostic_procedure expression Lab_value for vimentin Diagnostic_procedure , smooth Diagnostic_procedure muscle Diagnostic_procedure actin Diagnostic_procedure ( SMA Diagnostic_procedure ), desmin Diagnostic_procedure ( focally Lab_value ) and CD99 Diagnostic_procedure .
Epithelial Diagnostic_procedure markers Diagnostic_procedure were not Lab_value expressed Lab_value .
The morphological and immunohistochemical appearances were in keeping with primary Detailed_description uterine Detailed_description osteoblastic Detailed_description variant Detailed_description of osteosarcoma Disease_disorder .
Unfortunately, despite treatment, further CT Diagnostic_procedure imaging Diagnostic_procedure showed the development of multiple Detailed_description peritoneal Biological_structure and pulmonary Biological_structure deposits Sign_symptom , confirmed on biopsy Diagnostic_procedure to be metastatic Detailed_description osteosarcoma Disease_disorder .
The patient received palliative Detailed_description chemotherapy Therapeutic_procedure and died Outcome several Date months Date later Date .