RESUMO
Extraskeletal osteosarcomas are extremely rare and account for < 1% of the soft tissue sarcomas. Most common site is in soft tissues of the lower extremities. Primary osteosarcomas of the breast are extremely rare and only a few cases have been reported in literature. It carries a very dismal prognosis in view of its high rate of local recurrence and distant spread. We report a case of primary osteosarcoma of the breast. A 44-year-old female presented with a 14 × 10 cm solid mass in right breast. She underwent wide excision and frozen section was consistent with metaplastic carcinoma. A possibility of malignant phyllodes tumor was kept therefore right axillary dissection was also done along with. Final histopathology was consistent with high-grade osteogenic sarcoma in view of haphazardly arranged spindle to stellate cells with presence of giant cells and a matrix showing osteoid and cartilaginous differentiation and on IHC tumor cells were positive for Vimentin, EMA, Pankeratin, and P 63 and negative for ER, PR, Her 2 neu, CK 7, CK 8/18, and CK 34. It is imperative to recognize this rare pathologic tumor variant in view of its need of multimodal management and overall poor prognosis. Immunohistochemistry plays an important part in establishing the diagnosis and hence the further management.
RESUMO
Iatrogenic nerve palsies due to faulty positioning on the operating table are commonly seen over the elbow and popliteal fossa. However, injury to the brachial plexus (BP) is rarely encountered and is a recently reported phenomenon due to the increasing number of complex surgeries including hepatobiliary surgical procedures. Brachial plexus injury (BPI) needs to be recognized as a potential complication of prolonged abdominal surgery. The present case report highlights the potential for BPI and its early recognition, management, and prevention in complex prolonged abdominal surgical procedures. BPI has been described in a 64-year-old patient following a prolonged right hepatectomy.
