Primary breast sarcoma in a male patient

Primary sarcoma of the breast is an extremely rare tumor in men. Furthermore, only a few cases of undifferentiated/unclassified sarcoma of the male breast have been reported in the literature. We report a case of primary undifferentiated sarcoma occurring in the male breast. A 66-year-old male patient presented with a rapidly growing ulcerative left breast lump. A large partially circumscribed, dense mass was noted on mammography which involved the overlying skin with contour bulge. Sonographic evaluation revealed a large hypervascular heteroechoic mass showing areas of internal necrosis. An initial core-needle biopsy suggested malignant phyllodes tumor, but final histopathology revealed a high-grade primary sarcoma with immunohistochemistry suggesting uncertain differentiation. A review of the literature is presented with focus on imaging and treatment of these unusual neoplasms.