MEMEDE KARSİNOSARKOM OLGUSU

Meme karsinosarkomu, sarkom benzeri bileşeni bulunan duktal tip karsinomayı ifade eden, malin epitelyal vemalin mezenkimal elemanların bir arada bulunduğu bir malinitedir. Glandüler epitelin glandüler olmayanmezenşimal dokuya farklanmasıyla ortaya çıkan ve seyrek görülen metaplastik meme kanserlerinin en seyrekgörülen alt tipidir. Tüm meme malinitelerinin %1'inden azını oluşturur. Literatürde karsinosarkomun radyolojiközelliklerinin değerlendirildiği sınırlı sayıda çalışma bulunmaktadır. Hastanemiz meme hastalıkları polikliniğinesol memede ele gelen kitle yakınmasıyla başvuran 44 yaşında kadın hastada fizik bakı, mamografi veultrasonografi bulguları değerlendirildi. Mamografi ve ultrasonografide lobüle, karma solid ve kistik alanlariçeren kitle izlendi. Histopatolojik olarak karsinosarkom tanısı alan olguda parsiyel mastektomi ve aksillerdiseksiyon yapıldı. Aksilladan çıkartılan 16 lenf nodunun biri metastatikti ve uzak metastaz saptanmadı. Bizimamacımız, nadir görülen bu tümörlerde radyolojik bulguları tanımlamak ve literatürü gözden geçirmektir

Anahtar Kelimeler:

Metaplastik meme kanseri, karsinosarkom, meme kanseri

Carcinosarcoma of the Breast: A Case Report

Carcinosarcoma of the breast represents a ductal carcinoma which consists sarcoma like component. Both malign epithelial and malign mesenchymal elements exist together in the breast carcinosarcoma. Glandular epithelium differentiates into non-glandular mesenchymal tissue, a process called metaplasia. Metaplastic breast malignancy is a rare type of the breast cancer, moreover carcinosarcoma is the rarest subtype which is less than 1% of the whole breast cancers. There are limited studies and case reports of carcinosarcoma in literature. Fourty-four aged woman applied to breast diseases polyclinic with palpable mass on her left breast. We evaluated the findings of the physical examination, mammography and ultrasound. On radiological evaluation we determined a lobulated complex mass with solid and cystic components. Histopathological examination resulted as carcinosarcoma. Lumpectomy and axillary dissection were performed. One axillary lymph node was metastatic out of 16 lymph nodes. There were no distant metastases. Our purpose is to define the radiologic findings about this rare tumour and to review the literature.

Keywords:

Metaplastic breast cancer, carcinosarcoma, breast cancer,

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1. American College of Radiology. Breast imaging reporting and data system (BI-RADS), 4th ed. Reston,VA:American College of Radiology, 2003.
2. Brenner RJ, Turner RR, Schiller V, Arndt RD, Giuliano A. Metaplastic carcinoma of the breast: report of three cases. Cancer 1998;82:1082-7.
3. Pitts WC, Rojas VA, Gaffey MJ, et al. Carcinomas with metaplasia and sarcomas of the breast.Am J Clin Pathol 1991;95:623632.
4. Wargotz ES, Norris HJ. Metaplastic carcinoma of the breast. I. Matrix-producing carcinoma. HumanPathol 1989;20:628-35.
5. Wargotz ES, Deos PH, Norris HJ. Metaplastic carcinoma of the breast. II. Spindle cell carcinoma. Human Pathol 1989;20:732-40.
6. Wargotz ES, Norris HJ. Metaplastic carcinoma of the breast. IV. Squamous cell carcinoma of ductal origin. Cancer 1990;65:272-6.
7. Wargotz ES, Norris HJ. Metaplastic carcinoma ofthe breast. III. Carcinosarcoma. Cancer 1989;64:1490-9.
8. Oberman HA. Metaplastic carcinoma of the breast. Am J Surg Pathol 1987;11:918-29.
9. Yang WT, Hennessy B, Broglio K, Mills C, Sneige N, Davis WG, Valero V, Hunt KK, Gilcrease MZ. Imaging differences in metaplastic and invasive ductal carcinomas of the breast.AJR 2007;189:1288-93.
10. Samuels TH, Miller NA, Manchul LA, DeFreitas G, Panzarella T. Squamous cell carcinoma of the breast. CanAssoc Radiol J 1996;47:177-82.
11. Park JM, Han BK, Moon WK, Choe YH, Ahn SH, Gong G. Metaplastic carcinoma of the breast: mammographic and sonographic findings. J Clin Ultrasound 2000;28:179-86.
12. Günhan-Bilgen I, Memis A, Emin Üstün E, Zekioglu O, Özdemir N. Metaplastic carcinoma of the breast: clinical, mammographic, and sonographic findings with histopathologic correlation. AJR 2002;178:1421- 5.
13. Velasco M, Santamaria G, Ganau S, Farrus B, Zanon G, Romagosa C, Fernandez PL. MRI of metaplastic carcinoma of the breast.AJR 2005;184:1274-8.