PMC5137636_01
Preoperative photograph showing right breast mass and incision lines for planned conservative breast approach
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fig1
A 35-year-old woman presented to the surgical outpatient clinic of the National Cancer Institute at Cairo University with a rapidly growing right breast mass (Fig 1). Incision was planned preoperatively with an inferior-based breast reduction plan (Fig 1).
Gross specimen following excision
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fig2
Complete excision of the mass was carried out with negative safety margins (Fig 2) confirmed by intraoperative frozen section.
Follow-up photograph one month after conservative breast surgery. There was no need for contralateral reduction mammoplasty. (No major discrepancy in breast symmetry.)
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fig3
Local glandular flaps were used to reconstruct the remaining breast volume (Fig 3) without major discrepancy in breast symmetry.
Gross specimen: tumour measured 19cm x 9cm x 9cm; lobulated, firm, friable, whitish mass with few chondroid and wide myxoid areas with focal cystic change and haemorrhagic foci
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fig4
Gross and microscopic pictures of the excised mass (Figs 4-6) were consistent with the picture of rare extraskeletal chondrosarcoma, myxoid type.
Microscopic picture showing nodules separated by fibrous septa and populated by cellular groups of malignant small to medium-sized round cells lying in lacunar spaces and having vesicular nuclei and prominent nucleoli, disposed in a loose myxoid, focally chondrohyaline matrix. (Few tumour nodules showed peripheral rim of calcific shell. No epithelial component could be detected and the possibility of a malignant phyllodes tumour, a carcinosarcoma or a metaplastic carcinoma was therefore excluded.)
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fig5
Gross and microscopic pictures of the excised mass (Figs 4-6) were consistent with the picture of rare extraskeletal chondrosarcoma, myxoid type.
Immunohistochemistry showing a positive reaction of the tumour cells to S100 protein, and a negative reaction to casein kinase, calponin and actin
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fig6
Gross and microscopic pictures of the excised mass (Figs 4-6) were consistent with the picture of rare extraskeletal chondrosarcoma, myxoid type.