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. 2013;4(3):338-41.
doi: 10.1016/j.ijscr.2013.01.013. Epub 2013 Jan 26.

Hemangiopericytoma/solitary fibrous tumor of pectoralis major muscle mimicking a breast mass

Dimitrios Dragoumis  1 , Klearchos Desiris, Aikaterini Kyropoulou, Maria Malandri, Anthoula Assimaki, Aris Tsiftsoglou
Affiliations

Hemangiopericytoma/solitary fibrous tumor of pectoralis major muscle mimicking a breast mass

Dimitrios Dragoumis et al. Int J Surg Case Rep. 2013.

Abstract

Introduction: Hemangiopericytoma (HPC)/solitary fibrous tumor (SFT) is a very uncommon tumor of uncertain malignant behavior. In 1942, Stout and Murray first characterized these neoplasms as "vascular tumors arising from Zimmerman's pericytes" and till now hemangiopericytomas and solitary fibrous tumors of the soft tissues are regarded as features of the same entity in the soft tissue fascicle.

Presentation of case: We present a case of hemangiopericytoma/solitary fibrous tumor of the pectoralis major muscle in a 33-year-old female. She first noticed a painless mass in her right breast. Ultrasound of the breast revealed a large heterogeneously hypoechoic lesion within the pectoralis major muscle. Fine needle aspiration of the tumor did not produce any meaningful result. The lesion was completely removed by surgical resection. Histologically, the tumor had staghorn-like vasculature and immunohistochemistry for CD34 was positive, whereas desmin, smooth-muscle actin, S-100 protein, cytokeratins (AE1/AE3) and epithelial membrane antigen (EMA) were all negative. A diagnosis of hemangiopericytoma/solitary fibrous tumor was rendered.

Discussion: Tumors comprising the HPC/SFT spectrum represent a small subset of soft tissue sarcomas and are found virtually at any site in the body. Wide surgical resection can achieve favorable long-term survival.

Conclusion: Due to the rarity and unpredictable biological potential of these tumors, long-term follow-up is mandatory even after radical resection, because recurrence or development of metastasis may be delayed many years.

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Figures

Fig. 1
Fig. 1
(a) Targeted breast ultrasosongraphy revealing a heterogeneous hypoechoic lesion confined to the pectoralis major muscle. (b) Increased intratumoral and peritumoral blood flow on Doppler sonography.
Fig. 2
Fig. 2
(a) Histologic section showing spindle and ovoid cells, with moderately irregular, without atypia (Hematoxylin and Eosin stain; original magnification ×40). (b) Higher magnification microphotograph demonstrating the presence of thin branching vessels within the mass (Hematoxylin and Eosin stain; original magnification ×100).
Fig. 3
Fig. 3
Diffuse, strong immunohistochemical staining for CD34 of the spindle-cell component.
Fig. 4
Fig. 4
Negative expression of the neoplastic cells by (a) desmin, (b) smooth muscle actin, and (c) S-100 protein (Avidin Biotin ×200).
See this image and copyright information in PMC

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