Metastatic Alveolar Soft Part Sarcoma of the Breast

Abstract

etastases to the breast from a nonbreast primary malignancy are rare, with an incidence of 0.5% to 2.0% of all breast malignancies.1 Although metastases to the breast can arise from any primary malignancy, the common sources of blood-borne metastasis to the breast are melanoma and carcinoma of the lung, ovary, and stomach.2 Alveolar soft part sarcoma is a rare soft tissue malignancy of young adults that occurs most often in the soft tissue of the lower extremities and metastasizes early in the course of the disease 3 ; however, metastasis into the breast is extremely rare, and, to our knowledge, only 2 cases have been reported. 4,5 We report a case of metastatic alveolar soft part sarcoma of the breast with mammographic and sonographic findings of a round, discrete nodule with multiple enlarged vessels around the tumor and dilated intratumor vessels with profound color flow signals on conventional color Doppler sonography. Hwasun-eup, Hwasun-gun, Jeollanam-do 519-809, Korea. E-mail: nico1220@dreamwiz.com Case ReportA 29-year-old woman came to our hospital because of decreased visual acuity. She underwent brain magnetic resonance imaging, and multiple cerebral metastases were detected. Chest radiography and computed tomography also revealed multiple pulmonary nodules, consistent with hematogeneous metastases. She stated that she had a slow-growing mass in the left thigh at that time, but she had overlooked the mass because it had been present for more than 10 years and never had been painful before. She underwent a wide excision of the thigh mass, and a diagnosis of alveolar soft part sarcoma was made. She was given 3 courses of chemotherapy with vincristine, ifosfamide, and cisplatin. Seven months after chemotherapy, she noticed a painless palpable nodule in the right breast. On physical examination, a round, movable nodule, approximately 1.5 cm large, was palpated in the lower outer quadrant of the right breast. No axillary lymphadenopathy was palpa-

Sonographic imaging features of alveolar soft part sarcoma: Case series and literature review

“…In 1 case, the lesions showed enlarged vessels around the tumor and dilated intratumor vessels at the peripheral portion on grayscale ultrasonic imaging, and there were abundant color flow signals on color Doppler ultrasound. [ 14 ] These imaging manifestations are similar to those of primary ASPS but are not common in benign lesions, which indicates the vascular pathological feature of the tumor.…”

“…[8] In addition, our cases indicated additional imaging features: the appearance of tubular structures, which is in consistent with 2 other cases describing the vascular nature of this tumor. [8,14] Color Doppler ultrasound shows that these tubular structures are abundant colored flows. This finding has been reported to be a feature of this tumor and it has been described to exist at both the center and periphery of the tumor.…”