Occult breast cancer in a female with benign lesions

Occult breast cancer is a carcinoma discovered by the presence of axillary lymph node metastases without the detection of the primary breast tumor. The incidence of this very rare pathology is 0.3%–1.0%. The limited number of these cases does not allow for the precise management of this rare pathology and often, the breast cancer manifestation can take many years to become obvious. We report the case of a 35-year-old woman who presented to our department for annual breast screening examination, without any symptoms. At the time of visit, there were two right and one left tumefactions; unfixed and palpable. Ultrasonography examination confirmed the lesions to be benign. One year later, a palpable hypoechoic axillary left lesion appeared: a lymph node with doubtful morphology. On cytological examination, a biopsy was performed for the axillary left mass which showed irregular masses of large malignant cells with pleomorphism and mitotic figures that suggested a carcinoma. The management of this case is suggestive for cancer of unknown primary syndrome

Expression and significance of PTTG and Ki67 in fibroadenomatosis and fibroadenomas / 中华内分泌外科杂志

Objective To explore the relationship between pituitary tumor transforming gene(PTIG) and Ki67 expression and their significance in multiple adolescent breast fibroadenomas (fibroadenomatosis)and single persons(fibroadenomas) and their clinical value.Methods A total of 53 fibroadenomatosis and 160 fibroadenomas specimens in our hospital were collected.All the samples were fixed with 10％ formalin and then embedded with paraffin.The protein expression of PTTG and Ki67 was detected by immunohistochemical staining.The relation between expression of PTTG and Ki67 in fibroadenomatosis was analyzed.Results The positive rate of PTTG and Ki67 was higher in fibroadenomatosis than in fibroadenomas (P ＜ 0.005).Conclusions High expression of PTTG and Ki67 in fibroadenomatosis leads to the proliferation of tumor cell and upregulates tumor angiogenesis.High expression of PTTG and Ki67 may play important roles in tumorigenesis and pathological process of fibroadenomatosis.

Cytologic Features of Benign Phyllodes Tumors as Compared to Fibroadenomas of the Breast / 대한세포병리학회지

Phyllodes tumor(PT) is a rare distinctive fibroepithelial breast tumor that occasionally shows unpredictable clinical behavior. Wide excision should be the primary treatment of PT and enucleation, the standard procedure for fibroadenoma(FA), is proscribed due to high frequency of local recurrence. Therefore an accurate preoperative diagnosis of PT is essential in order to ensure proper surgical treatment. However, the differentiation between benign PT and FA is often difficult on the basis of cytologic findings. In an attempt to better understand the cytologic features of benign PT and possibly to differentiate PT from FA on the findings of fine needle aspiration(FNA)smears, we reviewed cytologic smears from 22 histologically diagnosed cases each of benign PT and FA, respectively. The cytologic features assessed were cellularity and atypia of both epithelial and stromal components, and shape of epithelial cell clusters. Atypia of stromal cells was more frequent in PT, while blunt branching pattern of epithelial cells was more frequent in FA. The specific cytologic diagnosis of PT is not possible in many cases, but the abundance of stromal cells with moderate nuclear atypia in the correct clinical setting such as older age and larger size(>4cm) allows the diagnosis.