PRIMARY BREAST MYXOFIBROSARCOMA MIMICKING DESMOID FIBROMATOSIS: A DIAGNOSTIC PITFALL AND SURGICAL MANAGEMENT OF A GIANT TUMOR

Resume. Primary mixed fibrosarcoma of the breast is an extremely rare malignant mesenchymal tumour. We present the clinical case of a 55-year-old woman and describe a rapidly enlarging mass in the left breast measuring approximately 20 × 19 cm. The core-needle biopsy report suggested a diagnosis of desmoid fibromatosis. Radiological investigations revealed a fairly large, heterogeneous tumour occupying almost the entire breast. Given the locally advanced nature of the disease and the severe pain, the patient underwent surgical treatment — a mastectomy with axillary lymph node dissection. Histological examination revealed spindle-shaped tumour cells arranged in intersecting bundles within a pronounced myxoid matrix with a characteristic tortuous vascular pattern. Immunohistochemical examination confirmed the diagnosis of primary breast myxofibrosarcoma (G1) with negative surgical margins (R0). This report expands the limited literature on primary breast myxofibrosarcoma and highlights the need to consider rare sarcomas in the differential diagnosis of large spindle cell tumours of the breast. Key words: myxofibrosarcoma, breast sarcoma, spindle cell tumor, diagnostic challenge.

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