Fine needle aspiration of primary pleomorphic liposarcoma of the breast - A case report

BACKGROUND: Primary liposarcoma of the breast is an extremely rare lesion. Only two cases describing the aspiration biopsy findings have been reported in the literature. We report the cytologic findings in an additional case, stressing the cytologic clues necessary to distinguish this neoplasm from a primary adenocarcinoma. CASE: A 53-year-old female presented to the emergency room with bleeding fr om a 20-cm, ulcerating mass in the right breast. Four months earlier she ha d been seen at another institution, where a diagnosis of poorly differentia ted carcinoma was made by aspiration biopsy. Computed tomography had been n egative for metastatic disease, and the patient refused further evaluation. Aspiration biopsy of the breast mass was repeated at our institution and i nterpreted as consistent with a poorly differentiated carcinoma. Histologic , immunophenotypic and ultrastructural evaluation of the mastectomy specime n revealed It pleomorphic liposarcoma. CONCLUSION: With increasing utilization of fine needle aspiration to evalua te breast lesions, it can be anticipated that unusual entities, including l iposarcomas, will be encountered increasingly in breast aspirates. Therefor e, it is important to consider liposarcoma in the differential diagnosis of aspirates showing isolated spindle and polygonal cells with vacuolated cyt oplasm, nuclear scalloping and pleomorphism to avoid a misdiagnosis of carc inoma.