title: Breast metastasis from uterine leiomyosarcoma diagnosed by fine needle aspiration: a case report.
abstract: BACKGROUND
  Leiomyosarcomas of the breast are a rare subgroup of primary breast sarcomas. Even more rare is breast metastasis of an extramammary leiomyosarcoma. To date, only 4 cases have been reported in the literature.
  
  
  METHODS
  We report a case of breast metastatic leiomyosarcoma in a 58-year-old woman with a prior history of uterine leiomyosarcoma, resected 18 months earlier. The breast mass was palpable and a fine needle aspiration (FNA) was performed. The microscopic examination showed cellular smears composed of loosely structured clusters and tissue fragments of spindle-shaped and polygonal or rounded malignant cells in disorderly arrangement. The tumor cells were medium- or large-sized, with basophilic cytoplasm and enlarged, irregular, hyperchromatic nuclei with nucleoli. Tumor giant cells and multinucleation were also present. The morphologic features along with immunocytochemical positivity for desmin, muscle-specific actin and vimentin indicated the diagnosis of a metastatic leiomyosarcoma.
  
  
  CONCLUSIONS
  FNA cytology can be a reliable method for the diagnosis of leiomyosarcoma. The morphologic criteria in combination Swith the clinical history and the immunocytochemical findings can indicate a definitive diagnosis and avoid additional painful and time-consuming diagnostic procedures for the appropriate patient's further clinical management.
authors.affiliation: Department of Cytopathology, University Hospital of Ioannina, Greece.
authors.forename: Lina
authors.initials: L
authors.lastname: Pappa
authors.forename: Nektaria
authors.initials: N
authors.lastname: Zagorianakou
authors.forename: Evangelia
authors.initials: E
authors.lastname: Kitsiou
authors.forename: Evdoxia
authors.initials: E
authors.lastname: Sintou-Mantela
authors.forename: Maria
authors.initials: M
authors.lastname: Bafa
authors.forename: Vassiliki
authors.initials: V
authors.lastname: Malamnou-Mitsi
mesh_terms: D044963:Biopsy, Fine-Needle; D001943:Breast Neoplasms / Q000556:secondary*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007890:Leiomyosarcoma / Q000556:secondary*; D008875:Middle Aged; D014594:Uterine Neoplasms / Q000473:pathology*