Undifferentiated pleomorphic breast sarcoma in a male patient

Objective: The objective of this case report is to present a rare case of inflammatory undifferentiated pleomorphic sarcoma in a male breast. Case report: a 64-year-old man palpated a painless nodule on the left breast. Core needle biopsy did not reveal the final diagnosis as it was classified as B3 so an excisional biopsy of the tissue was performed, which revealed an undifferentiated pleomorphic sarcoma with a diameter of 4.5 cm, infiltrated with inflammatory cells. After we confirmed the sarcoma operation therapy was indicated. Stewart incision was performed and mastectomy was done. Pathohistological analysis confirmed negative surgical resection margins. After one month PET CT scan revealed lungs metastases and the patient underwent 6 chemotherapy cycles of doxorubicin with good response and contribution of lungs metastases remission. Three years later, the tumor recurred and infiltrated the thoracic wall. The patient underwent again to surgical procedure. We did the extirpation of tumor, resection of thoracic wall with large pectoral muscle and within fifth, sixth and seventh ribs resection and thoracoplasty with core matrix and bio-net was performed for reconstruction of the defect. On pathohistology findings distal resection margin was infiltrated by tumor cells so radiotherapy was performed. Larger thoracic resection was not possible as it would affect breathing mechanics. The postoperative course was normal, without paradoxical breathing. The patient has been in remission according to PET-CT examination for four years after them treatment. Conclusion: We have presented a rare case of undifferentiated pleomorphic sarcoma in the breast, its potential for recurrence and distant metastases, the possibilities of treatment, the importance and limitations of operative treatment as well as benefit of oncological procedures and unpredictable clinical course of disease.