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Case Report Open Access

Primary breast osteosarcoma: A case report and mini‑review of the literature

  • Authors:
    • Ari M. Abdullah
    • Abdulwahid M. Salih
    • Lana R.A. Pshtiwan
    • Soran H. Tahir
    • Shaban Latif
    • Rebaz M. Ali
    • Rawa M. Ali
    • Hiwa O. Abdullah
    • Meer M. Abdulkareem
    • Vanya I. Jwamer
    • Abdullah A. Qadir
    • Fahmi H. Kakamad
  • View Affiliations / Copyright

    Affiliations: Department of Scientific Affairs, Smart Health Tower, Sulaymaniyah 46001, Iraq
    Copyright: © Abdullah et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY 4.0].
  • Article Number: 99
    |
    Published online on: August 27, 2025
       https://doi.org/10.3892/wasj.2025.387
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Abstract

Primary breast osteosarcoma (PBO) is an exceedingly rare form of breast cancer. The present study reports the case of a 45‑year‑old female patient with PBO with atypical manifestations. The patient sought medical consultation due to a painful, slowly growing lump in her left breast for 2 months. Upon a physical examination, a palpable mass was noted in the left upper outer quadrant. The mass was ill‑defined, hard, tender and immobile. There was no axillary lymphadenopathy. A core needle biopsy from the mass indicated a breast fibroadenoma with focal inflammation and a giant cell reaction, while the axillary lymph nodes were benign. The patient underwent wide local excision of the left breast without axillary lymph node management. No adjuvant chemotherapy or radiotherapy was prescribed. The detailed pathogenesis of PBO is not yet fully understood. Different origins and predisposing factors have been proposed. Complete removal of the mass with clear margins seems to be the most effective medical intervention. The significance of adjuvant chemotherapy and radiation therapy is still a matter of debate. Due to its rarity, PBO can be challenging to diagnose pre‑operatively, necessitating a detailed histological examination of the resected specimen along with immunohistochemistry to reach an accurate diagnosis.
View Figures

Figure 1

Ultrasound of the upper outer quadrant
of the left breast illustrating a heterogeneous hypoechoic lesion
with an indistinct margin. The lesion was a complex cyst connected
to a lobulated solid mass, collectively measuring 35x27 mm in
size.

Figure 2

Mammography illustrating an obscured
outline and equal-density mass in the upper outer quadrant of the
left breast (red circle), with a Breast Imaging-Reporting and Data
System score of M3.

Figure 3

Breast magnetic resonance imaging. (A)
T1 fat suppression pre-contrast; (B) post-contrast. A small 115-mm
homogeneously enhanced mass can be observed (blue arrow). The mass
was connected to a complex cystic lesion (white arrow).

Figure 4

Immunohistochemical staining. (A) The
tumor cells lying among congested pseudovascular spaces with
intervening fibrosis. (B) The presence of amorphous, hyaline,
osteoid-like material with entrapped benign breast ducts (showing a
two-layered lining) and numerous multinucleated giant cells can be
observed. (C) The tumor cells are epithelioid and moderately
pleomorphic, with oval, hyperchromatic nuclei that have irregular
outlines. The cells lie among hemorrhagic pseudovascular spaces
with numerous multinucleated giant cells. Mitotic activity is
easily visible. (D) There are numerous multinucleated giant cells
and pseudovascular spaces within the tumor. (E) There is nuclear
staining of moderate intensity in the tumor cells for SATB2. (F)
The multinucleated giant cells show membranous staining of moderate
intensity for CD68, while the tumor cells are negative. (A-D)
hematoxylin and eosin staining. (E and F) Immunohistochemistry
using diaminobenzidine chromogen. Original magnification: (A) x40,
(B, and E-F) x100, and (C and D) x400.

Figure 5

Maximum intensity projection image of
whole-body Diffusion-weighted magnetic resonance imaging sequence
illustrating bilateral small inflammatory axillary lymph nodes
(blue arrows).

Figure 6

Positron emission tomography-computed
tomography illustrating an irregular area of mild FDG uptake, with
a low mean standardized uptake value, indicating post-operative
inflammatory changes (white arrow).
View References

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Related Articles

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Copy and paste a formatted citation
Spandidos Publications style
Abdullah AM, Salih AM, Pshtiwan LR, Tahir SH, Latif S, Ali RM, Ali RM, Abdullah HO, Abdulkareem MM, Jwamer VI, Jwamer VI, et al: Primary breast osteosarcoma: A case report and mini‑review of the literature. World Acad Sci J 7: 99, 2025.
APA
Abdullah, A.M., Salih, A.M., Pshtiwan, L.R., Tahir, S.H., Latif, S., Ali, R.M. ... Kakamad, F.H. (2025). Primary breast osteosarcoma: A case report and mini‑review of the literature. World Academy of Sciences Journal, 7, 99. https://doi.org/10.3892/wasj.2025.387
MLA
Abdullah, A. M., Salih, A. M., Pshtiwan, L. R., Tahir, S. H., Latif, S., Ali, R. M., Ali, R. M., Abdullah, H. O., Abdulkareem, M. M., Jwamer, V. I., Qadir, A. A., Kakamad, F. H."Primary breast osteosarcoma: A case report and mini‑review of the literature". World Academy of Sciences Journal 7.6 (2025): 99.
Chicago
Abdullah, A. M., Salih, A. M., Pshtiwan, L. R., Tahir, S. H., Latif, S., Ali, R. M., Ali, R. M., Abdullah, H. O., Abdulkareem, M. M., Jwamer, V. I., Qadir, A. A., Kakamad, F. H."Primary breast osteosarcoma: A case report and mini‑review of the literature". World Academy of Sciences Journal 7, no. 6 (2025): 99. https://doi.org/10.3892/wasj.2025.387
Copy and paste a formatted citation
x
Spandidos Publications style
Abdullah AM, Salih AM, Pshtiwan LR, Tahir SH, Latif S, Ali RM, Ali RM, Abdullah HO, Abdulkareem MM, Jwamer VI, Jwamer VI, et al: Primary breast osteosarcoma: A case report and mini‑review of the literature. World Acad Sci J 7: 99, 2025.
APA
Abdullah, A.M., Salih, A.M., Pshtiwan, L.R., Tahir, S.H., Latif, S., Ali, R.M. ... Kakamad, F.H. (2025). Primary breast osteosarcoma: A case report and mini‑review of the literature. World Academy of Sciences Journal, 7, 99. https://doi.org/10.3892/wasj.2025.387
MLA
Abdullah, A. M., Salih, A. M., Pshtiwan, L. R., Tahir, S. H., Latif, S., Ali, R. M., Ali, R. M., Abdullah, H. O., Abdulkareem, M. M., Jwamer, V. I., Qadir, A. A., Kakamad, F. H."Primary breast osteosarcoma: A case report and mini‑review of the literature". World Academy of Sciences Journal 7.6 (2025): 99.
Chicago
Abdullah, A. M., Salih, A. M., Pshtiwan, L. R., Tahir, S. H., Latif, S., Ali, R. M., Ali, R. M., Abdullah, H. O., Abdulkareem, M. M., Jwamer, V. I., Qadir, A. A., Kakamad, F. H."Primary breast osteosarcoma: A case report and mini‑review of the literature". World Academy of Sciences Journal 7, no. 6 (2025): 99. https://doi.org/10.3892/wasj.2025.387
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