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Malignant peripheral nerve sheath tumor of the breast: case report

DOI: 10.1186/1477-7819-5-142

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Abstract:

A 38-year-old female presented with complaints of painless, hard breast lump for three months which was clinically suspected to be a ductal carcinoma with inconclusive fine needle aspiration cytology. Histopathology revealed a malignant spindle cell tumor which was confirmed to be malignant peripheral nerve sheath tumor on the basis of immunopositivity for vimentin, neurone specific enolase and S-100.To the best of our knowledge only six such case reports have been published in literature. The differential diagnosis of malignant peripheral nerve sheath tumor should be considered by the clinician as well as the pathologists in the work-up of a breast neoplasm as treatment and prognosis of this rare malignancy is different.Malignant peripheral nerve sheath tumor (MPNST) is a rare soft tissue sarcoma of the ectomesenchymal origin. It is the malignant counterpart of benign soft tissue tumors like neurofibromas and schwannomas and may follow them. Common sites include deeper soft tissues, usually in the proximity of a nerve trunk. MPNST in the breast is often unsuspected and the diagnosis may be missed unless clinical suspicion is high and immunohistochemistry carried outA 38-year old female patient presented to the surgical out patient department with complaints of a rapidly growing right breast lump for three months. There was no history of prior breast mass, pain, trauma, bleeding, discharge, or family history of breast cancer. On examination there was a single 3.5 × 3 × 3 cm, ill defined non tender, firm, fixed mass in the right upper outer quadrant. There was no retraction or ulceration of the overlying skin. Fine needle aspiration cytology (FNAC) suggested a malignant spindle cell tumor probably a malignant phylloides. An excisional biopsy was advised to confirm the diagnosis and to guide the further management.Grossly the specimen was a skin covered lumpectomy specimen measuring 5 × 4.4 × 4 cms. The cut sections revealed a firm infiltrative unencapsulated gray whi

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