Asian Journal of Case Reports in Surgery

Background: Liposarcoma of the breast is a rare entity accounting for 0.3% of breast sarcomas which in turn are responsible for less than 1% of breast malignancies. We present this case for rarity and for its being a histological surprise.

Case Summary:  We are reporting a case of 60 years female presenting with painless, progressively increasing lump in the right breast for 4 months. Examination revealed a 6*5 cm, firm, nontender, mobile, lump with smooth surface and clear margins in the right upper outer quadrant. Ultrasonography of breasts and mammography were suggestive of BIRADS III lesion. Trucut biopsy was suggestive of fibroepithelial lesion with cellular stroma. Keeping in view the age of the patient and size of the lump, excision biopsy was done. Histopathology report revealed liposarcoma arising in the fibrocellular stroma. Completion surgery with re-excision of the margins was done in the 2^nd stage. Patient was asymptomatic with no evidence of recurrence after 1.5 years of follow up.

Discussion: Most of the liposarcomas have been found to arise in malignant phyllodes tumors, as opposed to primary liposarcomas of the breast which arise de novo from fibrocellular stroma. Our case was liposarcoma of breast which was identified on histopathology after excisional biopsy and was managed well with re-excision of the margins as per NCCN guidelines.

Conclusion: Liposarcoma of breast is rare. It can present as a benign lesion clinically. Treatment is by wide local excision with tumour-free margins or re-resection of margins in case of a histological surprise.