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Rare disease
Case report
Imaging characteristics of metaplastic breast cancer with osteoblastic differentiation
  1. Sara Twadell1,
  2. Kathy Schilling2,
  3. Aaron Gleckman3 and
  4. Kerry-Ann McDonald4
  1. 1Charles E Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida, USA
  2. 2Department of Breast Imaging, Lynn Women's Health and Wellness Institute, Boca Raton, Florida, USA
  3. 3Department of Pathology, Boca Raton Regional Hospital Inc, Boca Raton, Florida, USA
  4. 4Department of Breast Surgical Oncology, Lynn Women's Health and Wellness Institute, Boca Raton, Florida, USA
  1. Correspondence to Sara Twadell; stwadell2018{at}health.fau.edu

Abstract

An 82-year-old female presented to her breast surgeon with a hard, painful mass in the left breast. Mammography demonstrated a new hyperdense mass with pleomorphic calcifications of trabeculated appearance. Ultrasound-guided biopsy demonstrated a hypoechoic mass with significantly increased vascularity and tissue stiffness as well as additional irregular, hypoechoic masses in the same area. Together these findings suggested multifocal malignancy. The pathology report from the biopsy demonstrated fragments of solid sheets of epithelioid and focally spindled cells with multinucleated osteoclast giant cells. This was found to be most consistent with metaplastic carcinoma showing osteoblastic differentiation. The patient received a left-sided mastectomy. During follow-up with the patient, adjuvant chemotherapy was not advised given the relatively unknown survival advantage in this elderly patient.

  • breast cancer
  • breast surgery
  • radiology

https://doi.org/10.1136/bcr-2020-235050

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    Footnotes

    • Contributors KS and KAMcD: conception and design. KS, KAMcD and AG: acquisition of data. ST, KS, KAMcD and AG: analysis and interpretation of data. All authors: writing, review and/or revision of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.