Journal of Pathology and Translational Medicine

Original Articles

A multicenter study of interobserver variability in pathologic diagnosis of papillary breast lesions on core needle biopsy with WHO classification: Hye Ju Kang, Sun Young Kwon, Ahrong Kim, Woo Gyeong Kim, Eun Kyung Kim, Ae Ree Kim, Chungyeul Kim, Soo Kee Min, So Young Park, Sun Hee Sung, Hye Kyoung Yoon, Ahwon Lee, Ji Shin Lee, Hyang Im Lee, Ho Chang Lee, Sung Chul Lim, Sun Young Jun, Min Jung Jung, Chang Won Jung, Soo Youn Cho, Eun Yoon Cho, Hye Jeong Choi, So Yeon Park, Jee Yeon Kim, In Ae Park, Youngmee Kwon; J Pathol Transl Med. 2021;55(6):380-387. Published online October 6, 2021; DOI: https://doi.org/10.4132/jptm.2021.07.29

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Background
Papillary breast lesions (PBLs) comprise diverse entities from benign and atypical lesions to malignant tumors. Although PBLs are characterized by a papillary growth pattern, it is challenging to achieve high diagnostic accuracy and reproducibility. Thus, we investigated the diagnostic reproducibility of PBLs in core needle biopsy (CNB) specimens with World Health Organization (WHO) classification.
Methods
Diagnostic reproducibility was assessed using interobserver variability (kappa value, κ) and agreement rate in the pathologic diagnosis of 60 PBL cases on CNB among 20 breast pathologists affiliated with 20 medical institutions in Korea. This analysis was performed using hematoxylin and eosin (H&E) staining and immunohistochemical (IHC) staining for cytokeratin 5 (CK5) and p63. The pathologic diagnosis of PBLs was based on WHO classification, which was used to establish simple classifications (4-tier, 3-tier, and 2-tier).
Results
On WHO classification, H&E staining exhibited ‘fair agreement’ (κ = 0.21) with a 47.0% agreement rate. Simple classifications presented improvement in interobserver variability and agreement rate. IHC staining increased the kappa value and agreement rate in all the classifications. Despite IHC staining, the encapsulated/solid papillary carcinoma (EPC/SPC) subgroup (κ = 0.16) exhibited lower agreement compared to the non-EPC/SPC subgroup (κ = 0.35) with WHO classification, which was similar to the results of any other classification systems.
Conclusions
Although the use of IHC staining for CK5 and p63 increased the diagnostic agreement of PBLs in CNB specimens, WHO classification exhibited a higher discordance rate compared to any other classifications. Therefore, this result warrants further intensive consensus studies to improve the diagnostic reproducibility of PBLs with WHO classification.

Citations

Citations to this article as recorded by

Invasive papillary carcinoma of the breast
Shijing Wang, Qingfu Zhang, Xiaoyun Mao
Frontiers in Oncology.2024;[Epub] CrossRef
Recommendations for Performance Evaluation of Machine Learning in Pathology: A Concept Paper From the College of American Pathologists
Matthew G. Hanna, Niels H. Olson, Mark Zarella, Rajesh C. Dash, Markus D. Herrmann, Larissa V. Furtado, Michelle N. Stram, Patricia M. Raciti, Lewis Hassell, Alex Mays, Liron Pantanowitz, Joseph S. Sirintrapun, Savitri Krishnamurthy, Anil Parwani, Giovann
Archives of Pathology & Laboratory Medicine.2024; 148(10): e335. CrossRef
Encapsulated papillary carcinoma of the breast: A single institution experience
Liang Xu, Qixin Mao, Qiuming Liu, Yufeng Gao, Lihua Luo, Chungen Guo, Wei Qu, Ningning Yan, Yali Cao
Oncology Letters.2023;[Epub] CrossRef
High-risk and selected benign breast lesions diagnosed on core needle biopsy: Evidence for and against immediate surgical excision
Aparna Harbhajanka, Hannah L. Gilmore, Benjamin C. Calhoun
Modern Pathology.2022; 35(11): 1500. CrossRef

CellprepPlus(R) Liquid-based Smear in Sono-guided Thyroid Fine Needle Aspiration: A Comparison of Conventional Method and CellprepPlus(R) Liquid-based Cytology.: Ji Hae Koo, Seung Young Lee, Ho chang Lee, Jin Woo Park, Sung Soo Koong, Tae Keun Oh, Hyun Jeong Jeon, Eun Joong Kim, Ok Jun Lee; Korean J Pathol. 2011;45(2):182-187.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.2.182

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Abstract PDF

BACKGROUND
Fine needle aspiration (FNA) of the thyroid is a useful tool for the evaluation of benign or malignant thyroid nodules. The improvements in the quality of cytological preparations using the liquid-based cytology (LBC) method have been well-documented. The principal objective of this study was designed to evaluate the diagnostic adequacy, sensitivity, and specificity of the thyroid FNA comparing a conventional smear with the LBC adapted with the filtration method described herein.
METHODS
One hundred ninety eight cases of FNA samples obtained from May 2009 to September 2009 were included in this study. All patients were subjected to ultrasound-guided aspiration twice at a target lesion by a radiologist and two types of slides were prepared using conventional smear and LBC.
RESULTS
When compared with conventional method, the cellularity was reduced in LBC. However, the malignant tumor cells evidenced the larger and more vesicular nuclei, prominent nucleoli, and distinct nuclear membranes in LBC. Thirty two cases (16.16%) of conventional smear were inadequate, but 96 cases (48.49%) of LBC were inadequate.
CONCLUSIONS
Most of the slides using CellprepPlus(R) LBC evidenced lower cellularity and clearer background. However, the conventional smears were found to generate much more applicable samples than CellprepPlus(R) LBC.

Citations

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Comparison of Liquid-Based Preparations with Conventional Smears in Thyroid Fine-Needle Aspirates: A Systematic Review and Meta-Analysis
Yun Jin Kang, Hyeon Woo Lee, Gulnaz Stybayeva, Se Hwan Hwang
Cancers.2024; 16(4): 751. CrossRef
The efficacy of pancreatic juice cytology with liquid-based cytology for evaluating malignancy in patients with intraductal papillary mucinous neoplasm
Kazuya Miyamoto, Kazuyuki Matsumoto, Hironari Kato, Ryuichi Yoshida, Yuzo Umeda, Hirohumi Inoue, Takehiro Tanaka, Akihiro Matsumi, Yosuke Saragai, Yuki Fujii, Tatsuhiro Yamazaki, Daisuke Uchida, Takeshi Tomoda, Shigeru Horiguchi, Takahito Yagi, Hiroyuki O
BMC Gastroenterology.2020;[Epub] CrossRef
Comparison of liquid-based cytology (CellPrepPlus) and conventional smears in pancreaticobiliary disease
Myeong Ho Yeon, Hee Seok Jeong, Hee Seung Lee, Jong Soon Jang, Seungho Lee, Soon Man Yoon, Hee Bok Chae, Seon Mee Park, Sei Jin Youn, Joung-Ho Han, Hye-Suk Han, Ho Chang Lee
The Korean Journal of Internal Medicine.2018; 33(5): 883. CrossRef
Comparison of EASYPREP® and SurePath® in thyroid fine‐needle aspiration
Yosep Chong, Ki Hyun Baek, Jee Young Kim, Tae‐Jung Kim, Eun Jung Lee, Chang Suk Kang
Diagnostic Cytopathology.2016; 44(4): 283. CrossRef
Conventional smears versus liquid-based preparations for thyroid fine-needle aspirates: a systematic review and meta-analysis
Neeraja Nagarajan, Alireza Najafian, Eric B. Schneider, Martha A. Zeiger, Matthew T. Olson
Journal of the American Society of Cytopathology.2015; 4(5): 253. CrossRef
Evaluation of Urine Cytology in Urothelial Carcinoma Patients: A Comparison of CellprepPlus® Liquid-Based Cytology and Conventional Smear
Seung-Myoung Son, Ji Hae Koo, Song-Yi Choi, Ho-Chang Lee, Yong-Moon Lee, Hyung Geun Song, Hae-Kyung Hwang, Hye-Suk Han, Seok-Joong Yun, Wun-Jae Kim, Eun-Joong Kim, Ok-Jun Lee
Korean Journal of Pathology.2012; 46(1): 68. CrossRef

Case Report

Urothelial (Transitional Cell) Carcinoma Arising in Mature Cystic Teratoma: A Case Report.: Ok Jun Lee, Ho chang Lee; Korean J Pathol. 2010;44(6):666-669.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.6.666

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Abstract PDF

Mature cystic teratoma (MCT) is one of the most common benign ovarian tumors, but 1-2% of MCTs are transformed to a malignant neoplasm. Urothelial carcinoma (UC) or transitional cell carcinoma is the most common cancer in the urinary tract. However, UC is a very rare component of transformed malignancy of MCT. Here we report a case of UC arising in an MCT in a 52-year-old woman. Grossly, the ovary was partly cystic and partly solid. Microscopically, the cyst revealed the classic features of MCT and the solid area was papillary UC. By immunohistochemistry using cytokeratins and thrombomodulin, the UC showed a similar expression to that of UC arising in the urinary tract, rather than resembling a primary transitional cell carcinoma of the ovary. When UC is found in a component of MCT, the origin of the carcinoma should be evaluated and urinary tract examinations are required to rule out metastasis.

Citations

Citations to this article as recorded by

A Rare Urothelial Malignant Transformation in a Mature Cystic Teratoma of the Ovary
Moito Iijima, Iori Kisu, Tetsuro Shiraishi, Rie Irie, Nobumaru Hirao
Cureus.2021;[Epub] CrossRef
Transitional Cell Carcinoma arising in Ovarian Cystic Teratoma: A Rare Case Report
Abhay V. Deshmukh, Vitaladevuni B. Shivkumar, Neha V. Fulzele, Nitin M. Gangane
Indian Journal of Gynecologic Oncology.2020;[Epub] CrossRef
A Rare Malignant Transformation of an Ovarian Cystic Teratoma: A Case Report
Manju Rachel Mathew, Anita Ramdas, Susy S. Kurian, Linu Kuruvilla, Neelima Singh
Case Reports in Pathology.2018; 2018: 1. CrossRef
Urothelial carcinoma arising from an ovarian mature cystic teratoma
Hui-Yu Chuang, Yi-Ting Chen, Tak-Loi Mac, Yu-Chieh Chen, Hung-Sheng Chen, Wan-Shan Wang, Eing-Mei Tsai
Taiwanese Journal of Obstetrics and Gynecology.2015; 54(4): 442. CrossRef

Original Article

Comparison of Cytologic Evaluation between Conventional Method and CellprepPlus(R) Liquid-Based Cytology in Body Fluid.: Ji Hae Koo, Ho Chang Lee, Hyung Geun Song, Hye Suk Han, Ki Hyeong Lee, Kang Hyeon Choe, Ki Man Lee, Ok Jun Lee; Korean J Pathol. 2009;43(5):448-452.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.5.448

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Abstract PDF

BACKGROUND
Assessment of body fluid cytology is a useful means of evaluating a metastatic tumor. Liquid-based cytology (LBC) has been developed as a replacement for the conventional Papanicolaou (CP) test. This study was performed to compare CellprepPlus(R) LBC with CP in cytologic diagnosis. METHODS: Body fluid samples (n=188, including 72 peritoneal fluid and 116 pleural fluid samples) were divided equally and analyzed by both CellprepPlus(R) and CP.
RESULTS
CellprepPlus(R) revealed distributed thin layers of non-overlapping cells. All CellprepPlus(R) preparations were adequate, while 18 (9.57%) CP preparations were inadequate. The respective diagnostic rates of CellprepPlus(R) and CP were 75.0% and 76.1% negative, 10.6% and 6.38% atypical, 5.85% and 2.66% suspicious, and 8.51% and 5.32% malignant. Of the 58 confirmed cases, the sensitivity of CellprepPlus(R) and CP was 94.4% and 73.3%, respectively, and the negative predictive value was 97.2% and 87.9%, respectively.
CONCLUSIONS
CellprepPlus(R) LBC has better sensitivity and negative predictive value, and produces higher quality slide preparations than than CP, making it suitable as in screening of body fluid as a cytologic diagnostic tool.

Citations

Citations to this article as recorded by

A COMPARATIVE STUDY OF CYTOLOGIC EVALUATION BETWEEN CONVENTIONAL METHOD & LIQUID BASED CYTOLOGY IN PLEURAL, PERICARDIAL & PERITONEAL FLUIDS
R. P. Siddiqui, Mohd. Jafar Memon, Shraddha Sahu
INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH.2020; : 1. CrossRef
Comparison of liquid-based cytology (CellPrepPlus) and conventional smears in pancreaticobiliary disease
Myeong Ho Yeon, Hee Seok Jeong, Hee Seung Lee, Jong Soon Jang, Seungho Lee, Soon Man Yoon, Hee Bok Chae, Seon Mee Park, Sei Jin Youn, Joung-Ho Han, Hye-Suk Han, Ho Chang Lee
The Korean Journal of Internal Medicine.2018; 33(5): 883. CrossRef
Comparison of diagnostic accuracy between CellprepPlus® and ThinPrep® liquid‐based preparations in effusion cytology
Yong‐Moon Lee, Ji‐Yong Hwang, Seung‐Myoung Son, Song‐Yi Choi, Ho‐Chang Lee, Eun‐Joong Kim, Hye‐Suk Han, Jin young An, Joung‐Ho Han, Ok‐Jun Lee
Diagnostic Cytopathology.2014; 42(5): 384. CrossRef
Evaluation of Urine Cytology in Urothelial Carcinoma Patients: A Comparison of CellprepPlus® Liquid-Based Cytology and Conventional Smear
Seung-Myoung Son, Ji Hae Koo, Song-Yi Choi, Ho-Chang Lee, Yong-Moon Lee, Hyung Geun Song, Hae-Kyung Hwang, Hye-Suk Han, Seok-Joong Yun, Wun-Jae Kim, Eun-Joong Kim, Ok-Jun Lee
Korean Journal of Pathology.2012; 46(1): 68. CrossRef
CellprepPlus® Liquid-based Smear in Sono-guided Thyroid Fine Needle Aspiration: A Comparison of Conventional Method and CellprepPlus® Liquid-based Cytology
Ji Hae Koo, Seung Young Lee, Ho-chang Lee, Jin-Woo Park, Sung Soo Koong, Tae Keun Oh, Hyun Jeong Jeon, Eun-Joong Kim, Ok-Jun Lee
The Korean Journal of Pathology.2011; 45(2): 182. CrossRef

Case Reports

The Cytologic Features of Desmoplastic Small Round Cell Tumor with Intranuclear Inclusions : A Case Report .: Ho Chang Lee, Hye Suk Han, Ok Jun Lee; Korean J Pathol. 2009;43(3):279-284.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.3.279

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Abstract PDF: Desmoplastic small round cell tumor (DSRCT) is a rare neoplasm of young adults and it is characterized by polyphenotypic differentiation. We experienced a case of abdominal DSRCT that occurred in a 19-year-old female who presented with painful swelling of her right forearm. The tumor was cytokeratin-negative and it exhibited some tumor cells with intranuclear inclusions. Molecular demonstration of EWS-WT1 fusion transcripts is particularly useful to confirm the diagnosis of DSRCT without epithelial differentiation. We report here on a case of cytokeratin-negative DSRCT that showed an unusual feature of intranuclear inclusions.

Cytologic Features of Epithelial-Myoepithelial Carcinoma Occurring in External Auditory Canal: A Case Report.: Ho chang Lee, Hyung Geun Song, Young Seok Choi, Ok Jun Lee; Korean J Cytopathol. 2008;19(1):52-56.; DOI: https://doi.org/10.3338/kjc.2008.19.1.52

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Abstract PDF: Epithelial-myoepithelial carcinoma (EMC) is a low grade malignant neoplasm that commonly occurs in the parotid gland. Recently, we investigated a case of EMC that occurred in the external auditory canal (EAC) in a 35-year-old male, and this tumor was initially diagnosed as pleomorphic adenoma. The difficulty associated with diagnosing EMC by aspiration cytology arises from both the rare incidence of this tumor and the overlapping spectrum of cytological features found in various salivary gland tumors, such as pleomorphic adenoma, basal cell adenoma and adenoid cystic carcinoma.

Original Articles

The Expression of G1-S Cell Cycle Inhibitors in Normal Placenta and Gestational Trophoblastic Diseases.: Yan Hua Xuan, Kyung Hee Kim, Yoon La Choi, Geung hwan Ahn, Seoung Wan Chae, Ho chang Lee, Ok Jun Lee, Seok Hyung Kim; Korean J Pathol. 2008;42(2):67-74.

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Abstract PDF: BACKGROUND
The objective of this study is to determine the expression pattern of G1-S inhibitor molecules in normal trophoblasts and gestational trophoblastic diseases, including hydatidiform moles and choriocarcinoma.
METHODS
A total of 157 cases comprising 47 normal placentas and 110 gestational trophoblastic diseases such as choriocarcinoma (19 cases) and hydatidiform moles (91 cases of which 58 were complete, 12 were partial and 21 were invasive mole) were immunohistochemically analyzed on paraffin blocks using anti-p21, antip27, anti-p16, anti-p53, anti-pRb antibodies.
RESULTS
The results revealed that in the normal placenta, all the G1-S cell cycle inhibitors were maximally expressed by the first-trimester trophoblasts and these levels decreased with gestational age. The expression of p21 and p53 was greatly enhanced in the gestational trophoblastic diseases, particularly in invasive mole and choriocarcinoma, whereas the p27 expression was significantly downregulated in choriocarcinoma. Especially, Rb expression was typically enhanced in the invasive mole, but not in choriocarcinoma. The expression level of p16 was low in all the cases, and particularly in choriocarcinoma.
CONCLUSIONS
In conclusion, we demonstrated that the expression of G1/S cell cycle inhibitors correlates well with normal trophoblast differentiation, and these expressions are considerably altered in the gestational trophoblastic diseases, including complete/partial/ invasive hydatidiform mole and choriocarcinoma.

Changes in Protein Expression in Breast Cancer after Anthracycline-Based Chemotherapy.: Ho chang Lee, Jae Ok Lee, In Ae Park; Korean J Pathol. 2007;41(3):165-170.

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Abstract PDF: Background
: Anthracyclines are the standard agents used to treat patients with advanced breast carcinoma. Some molecules are reportedly associated with anthracycline resistance; however, there has been some controversy surrounding these claims. The gain or loss of certain molecules after chemotherapy can explain the discrepancies in the results.
Methods
: We evaluated the expression levels of the estrogen receptor (ER), p53, and bcl-2 in specimens obtained from twenty patients with advanced breast cancer before and after anthracyclinebased chemotherapy using immunohistochemistry (IHC). We also examined HER2/neu expression in these specimens using IHC and fluorescence in situ hybridization (FISH) analysis.
Results
: After chemotherapy, one of the twenty cases (5%) showed decreased ER expression, one (5%) showed decreased p53 expression, and one (5%) showed increased bcl-2 expression. IHC and FISH analysis in pre- and post-chemotherapy specimens showed that the expression of HER2/neu changed from equivocal to negative in one case (5%).
Conclusion
: Our results showed that the expression levels of HER2/neu, ER, p53 and bcl-2 remained stable after chemotherapy, although the statistical significance of these results may not be validated due to the small number of cases. We also suggested that the resistance to anthracycline-based chemotherapy might not be associated with the modification of these molecules.

Causes of Hydrops Fetalis: Analysis of 149 Autopsy Cases.: Ho chang Lee, Je G Chi, Sung Hye Park; Korean J Pathol. 2007;41(2):103-108.

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Abstract PDF: BACKGROUND
Hydrops fetalis is defined as abnormal accumulation of serous fluid in two or more fetal compartments, and this malady is known to be associated with various pathologic conditions.
METHODS
We collected 149 cases of hydrops fetalis out of 2,312 autopsies, and we tried to elaborate the underlying causes of hydrops fetalis. The diagnosis was based on the material from either antenatal termination or intrauterine death.
RESULTS
The relative incidence of hydrops fetalis was 6.44% of all the pediatric autopsies we performed. The gestational age was evenly distributed from 18 to 33 weeks, except for 30 to 31 weeks. There was no sex difference in the incidence of hydrops fetalis. The main causes were cardiovascular diseases (30.9%), cystic hygroma (13.4%), chromosomal anomaly (8.05%), thoracic conditions (7.38%), followed by urinary tract malformation (4.03%), infection (4.03%) and anemia (3.36%). The most common chromosomal anomaly was Turner syndrome and the second one was Down syndrome.
CONCLUSION
Since various conditions can be the cause of hydrops fetalis, pathologists should pay attention to elaborate the underlying causes in every single autopsy.

Case Report

Hydrops Fetalis Due to Parvovirus B19 Infection: Report of Two Autopsy Cases.: Ho Chang Lee, Hee Eun Lee, Pil Gyu Hwang, Je G Chi, Sung Hye Park; Korean J Pathol. 2006;40(3):245-249.

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Abstract PDF: Hydrops fetalis (HF) is a disease characterized by generalized subcutaneous edema and cavity effusion in the fetal stage. We report here on two autopsy cases of HF that were caused by parvovirus B19 (PVB19) infection. The human PVB19 is an erythrovirus that cause diverse clinical manifestations ranging from an asymptomatic or mild presentation to more severe effects such as hydrops fetalis, and this is the only known human pathogenic parvovirus. The gestational ages of the two fetuses were 21 weeks and 23 weeks, respectively. Both fetuses were hydropic and anemic. Hepatic tissues of both fetuses demonstrated erythroblasts with eosinophilic intranuclear inclusions, the so called "lantern cells". PVB19 was confirmed by electron microscopy and immunohistochemical staining. For the diagnosis of this disease, recognition of parvovirus infection as a cause of hydrops fetalis and careful examination of red blood cells with a high-power view are required.

Original Article

Comparison of the Expression of Variants of CD44 between Node-positive and Node-negative Breast Carcinomas.: In Ae Park, Ho Chang Lee, Soo Youn Cho; Korean J Pathol. 2005;39(3):172-180.

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Abstract PDF: BACKGROUND
The purpose of this study is to determine the value of CD44 and its splice variants as markers for the metastatic potential of infiltrating ductal carcinomas of the breast.
METHODS
Tissue samples of infiltrating ductal carcinoma of the breast were examined for the expression of standard CD44 (CD44H) and s CD44 isoforms, v3, v4-5 and v6 in 41 node-positive and 31 node-negative cases. The immunohistochemistry results were correlated with other clinicopathologic parameters, and these results were correlated with accompanying high grade and non-high grade DCIS areas of the tumors in both node-positive and node-negative cases.
RESULTS
The expression of CD44 in the invasive tumor areas and in the metastatic foci of the lymph nodes showed a statistically significant correlation. The expression of CD44H in the invasive tumor areas and the DCIS area showed a statistically significant correlation in the lymph node (-) group. There was statistical significance between the CD44 H and CD44v3 expressions and the histologic grade of the invasive tumor in the cases with positive lymph nodes. There was no statistical significance between CD44 expression and lymph node metastasis, tumor size and type of tumor margin.
CONCLUSIONS
We conclude that changes in the CD44 expression in breast cancer occur early in breast carcinogenesis, and this is involved in tumor differentiation, but we could not establish any correlation between the expression of the CD44 variant isoforms and the metastasis of breast cancer.

Case Reports

Endometrial Mucinous Adenocarcinoma with Extensive Squamous Differentiation: A Case Report.: Ho chang Lee, Pil Gyu Hwang, Soo Youn Cho, Young S Park, In Ae Park; Korean J Pathol. 2003;37(6):438-441.

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Abstract PDF: Endometrial mucinous adenocarcinoma occurs in 1-9% of endometrial adenocarcinomas and adenocarcinoma with squamous differentiation in approximately 25%. We report a rare case of mucinous adenocarcinoma with squamous differentiation in a 53-year-old woman. Curetting biopsies of the endometrial lesion were taken twice after hormone replacement therapy, which lasted for four months. Because the squamous differentiation was so extensive, the initial diagnosis based on each curetting specimen was squamous papilloma. A total hysterectomy was performed and the tumor was revealed to be a mucinous adenocarcinoma with squamous differentiation. We subsequently discussed the pathogenesis and prognosis of this type of tumor.

Bilateral Mammary Metastasis of Alveolar Soft Part Sarcoma: A Case Report.: Soo Youn Cho, Ho Chang Lee, Chong Jai Kim, Min Suk Kim, Sun Hoo Park, Eui Keun Ham, In Ae Park; Korean J Pathol. 2003;37(5):365-368.

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Abstract PDF: An alveolar soft part sarcoma(ASPS) is a rare malignant soft tissue tumor, which metastasizes to the lung, bone and brain. Recently, we encountered an unusual case of a metastatic ASPS to the bilateral breasts in a 27-year-old woman. She had undergone surgery for an ASPS in her right thigh two years ago, which metastasized to the breast on three occasions, 15 months, 20 months and two years after surgery.

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