Ultrasonographic and pathological features of metaplastic carcinoma with squamous cell component of breast / 中国医学影像技术

Objective To observe the ultrasonographic and pathological features of metaplastic carcinoma with squamous cell component (MCSC) of the breast.Methods The ultrasonographic and pathological features of 7 patients with breast MCSC confirmed pathologically were retrospectively analyzed.Results Seven cases were single lesion and the maximal diameters of the lesions were 2.6-5.1 cm.On two-dimensional imaging,6 lesions with cystic and solid were complex echogenic,only 1 lesion was hypoechoic.All the lesions had irregular shape (lobulated)and indistinct margin.On CDFI imaging,most of lesions had rich blood flow signals with high resistance (resistance index 0.75-0.91),4 lesions were grade l,2 lesions were grade Ⅱ and 1 lesion was grade Ⅰ blood flow signals.On gross histopathological examination,6 masses had cystic cavity,only 1 mass was pure solid.On microscopic histopathological examination,5 masses were adenosqua mous carcinoma,only 2 masses were pure squamous cell carcinoma.Estrogen receptors,progesterone receptors and human epidermal growth factor receptor were negative in 4 masses (triple-negative breast cancer).Conclusion MCSC have some distinguished ultrasonic characteristics of larger volume,cystic-solid mixed echo,posterior echo enhancement,abundant vascularity with high resistance.

Metaplastic Carcinoma with Chondroid Differentiation Arising in Microglandular Adenosis

Microglandular adenosis (MGA) of the breast is a rare, benign proliferative lesion but with a significant rate of associated carcinoma. Herein, we report an unusual case of metaplastic carcinoma with chondroid differentiation associated with typical MGA. Histologically, MGA showed a direct transition to metaplastic carcinoma without an intervening atypical MGA or ductal carcinoma in situ component. The immunohistochemical profile of the metaplastic carcinoma was mostly similar to that of MGA. In both areas, all the epithelial cells were positive for S-100 protein, but negative for estrogen receptor, progesterone receptor, HER2/neu, and epidermal growth factor receptor. An increase in the Ki-67 and p53 labelling index was observed from MGA to invasive carcinoma. To the best of our knowledge, this is the first case of metaplastic carcinoma with chondroid differentiation arising in MGA in Korea. This case supports the hypothesis that a subset of MGA may be a non-obligate morphologic precursor of breast carcinoma, especially the triple-negative subtype.

Heterologous osseous differentiation in Malignant Phyllodes tumour – A rare case report

Breast sarcomas are rare neoplasms accounting for less than 1% of breast malignancy. Phyllodes tumors have biphasic histological features with both epithelial and stromal component. Careful characterization of the stromal component is critical since it is the pathologic features of the stromal cells that determine its malignant potential. We reported a case of 57 years old female with right breast mass who underwent wide excision and on histological examination a diagnosis of malignant phyllodes tumour with heterogonous osseous differentiation was made. The rarity of the lesion was considered for reporting and on follow up the patient was free of metastasis.

Metaplastic Carcinoma of Breast - Squamous Variant.

Metaplastic carcinoma of breast is a rare neoplasm. Although it is a tumor of ductal type, the predominant component may have appearance other than the glandular pattern and usually runs an aggressive course.

Metaplastic Carcinoma with an Adenomyoepithelioma Component : A Case Report

Metaplastic carcinoma of the breast is rare. We report a case in a 53-year-old woman who presented with a rapidly-growing breast mass. The lesion had a complex echogenicity in ultrasonography and a high signal intensity in a T2-weighted image with rim enhancement in contrast-enhanced MR images. The PET/CT images showed high uptake for the lesion. The lesion was biopsied and found to be a metaplastic carcinoma with an adenomyoepithelioma component. Although metaplstic carcinoma was difficult to differentiate from other common breast cancers, it showed complex echogenicity on ultrasonography and high signal intensity on a T2 weighted image with rim enhancement on contrast-enhanced MR images.

Carcinoma sarcomatoide monofásico de mama: caso clínico / Monophasic sarcomatoid carcinoma of the breast: clinical case

El carcinoma sarcomatoide de mama es una variante histológica del carcinoma metaplásico, compuesto predominantemente por células fusiformes. Presentamos el caso de un tumor en mujer de 54 años, en que las características clínicas y de imagen sugerían un tumor maligno, y finalmente la histología y la inmuno-histoquímica confirmaron el diagnóstico de carcinoma sarcomatoide monofásico. En esta variante no es posible identificar un componente epitelial claro, por lo que plantea problemas de diagnóstico diferencial con sarcomas y otras lesiones mesenquimatosas. La demostración mediante inmunohistoquímica de la naturaleza epitelial de las células fusiformes, resultó fundamental para establecer el diagnóstico.

Sarcomatoid carcinoma of the breast is a histological variant of metaplastic carcinoma, composed predominantly of spindle cells. We report a case of a tumor in a woman of 54 years old, which suggested a clinical and radiological malignant tumor. Finally the histology and immunohistochemistry confirmed the diagnostic of monophasic sarcomatoid carcinoma. In this variant of sarcomatoid carcinoma, is not possible to identify a clear epithelial component, creating problems of differential diagnosis between sarcomas and other mesenchymal damages. The immunohistochemical demonstration of epithelial nature of the spindle cells was essential for the diagnosis.

Metaplastic carcinoma of the breast-A rare neoplasm with transitional cell differentiation: An exceptional feature.

Metaplastic carcinomas of the breast are malignant breast neoplasms composed of a mixture of both epithelial and mesenchymal elements. The rarity of this tumor is exemplified by the fact that it accounts for only about 0.2% of all breast carcinomas. It can present histologically with diverse differentiation and the exact histogenesis of these tumors is unknown. The present case is reported for its rarity and for the presence of transitional cell differentiation along with the other usual components of metaplastic carcinoma. Transitional cell differentiation in a metaplastic carcinoma has not been documented in the literature. Besides this, it highlights the importance of special stains and immunohistochemistry in evaluating these carcinomas and the need for early diagnosis and excision of these tumors as these carcinomas generally have a poorer prognosis as compared to breast carcinomas without metaplasia, with the tumor size having an important bearing on the outcome of this condition.

Clinical and pathological characteristics of breast carcinosarcoma with osteosarcoma components / 中华内分泌外科杂志

Objective To investigate the clinicopathologic and immunohistochemical characteristics of breast carcinosarcoma with osteosarcoma components and its differential diagnosis. Methods The pathologic features and clinical manifestations of the two patients were retrospectively reviewed. Immunohistochemistry was performed and the literature was reviewed. Results Histopathologically, the neoplasm consisted of invasive ductal carcinoma of no special type and poorly ( case 1 ) or well (case 2) differentiated osteosarcomatoid elements. The morphological transition from carcinoma to sarcomatoid elements was seen. Immunohistochemically,the carcinoma cells were positive for CK and EMA , the sarcomatoid elements were stained positive for vimentin, and a few cells of two elements were positive for S-100 protein. Ki-67 and VEGF were over expressed in both elements of Case 1.In case2 Ki-67 expression was low in both elements and VEGF over expression was only seen in sarcomatoid elements. Some of the carcinoma cells were positive for ER. Conclusions Carcinosarcoma of the breast with osteosarcomatoid elements is a rare type of mixed epithelial/mesenchymal metaplastic breast carcinoma. The types and proportion of carcinoma and sarcomatoid elements determine the diagnosis.

Comparative Study of Metaplastic Breast Carcinoma and Triple-Negative Breast Carcinoma Using Histologic and Immunohistochemical Analyses

BACKGROUND: Metaplastic carcinoma of the breast is a rare subtype of breast cancer, which is characterized by estrogen receptor/progesterone receptor and HER2 negativity. METHODS: Tissue specimens from 60 metaplastic breast cancer and 60 triple-negative breast cancer patients diagnosed at a single institution between 1995 and 2009 were analyzed. Immunohistochemistry for caveolin-1 (CAV-1), vascular endothelial growth factor (VEGF), epidermal growth factor receptor (EGFR), c-kit, p53, Ki-67, breast cancer type 1 susceptibility protein (BRCA1), cytokeratin (CK)14, and CK17 were performed on both retained tissue sets. RESULTS: Of the 60 metaplastic carcinomas, 15 tumors (25%) exhibited spindle cell component, 27 (45%) exhibited chondroid differentiation, and 18 (30%) exhibited squamous areas. Compared to triple-negative carcinomas, metaplastic carcinomas significantly more frequently expressed CK14 (p < 0.0001), CK17 (p = 0.002), EGFR (p < 0.0001), CAV-1 (p < 0.0001), and VEGF (p = 0.029). However, expressions of BRCA1, p53, c-kit, and Ki-67 were not significantly different between both groups. CONCLUSIONS: The expression profile of metaplastic carcinoma of the breast is more homogeneous than that of other triple-negative tumors and frequently over-expresses basal markers, CAV-1, and VEGF. A typical "basal-like" phenotype and frequent expressions of CAV-1 and VEGF may justify specific therapeutic approaches.

Sarcomatoid Metaplastic Carcinoma of the Breast: A Case Report

Metaplastic breast carcinoma is a very rare disease with many different histologic subtypes including squamous cell, spindle cell, and heterologous mesenchymal growth (sarcomatoid, osseous). We report a case of sarcomatoid metaplastic carcinoma of the breast which was manifested as a well-circumscribed, round, hypoechoic mass on ultrasound.

Metaplastic Carcinoma of Breast.

Metaplastic carcinoma of breast is a rare neoplasm. Although it is a tumor of ductal type, the predominent component may have an appearance other than the glandular pattern and usually runs an aggressive course.

MR Findings of Metaplastic Carcinoma of the Breast: Case Report

We report the dynamic magnetic resonance imaging findings (MRI) of a metaplastic carcinoma of the breast. A 44-year-old woman presented with a 2-month history of a mass in the right breast. The tumor showed a central irregular necrosis that was depicted upon low signal intensity on a T1-weighted image and high signal intensity on a T2-weighted image. The periphery of the tumor showed strong enhancement on a contrast enhanced T1-weighted image. The time-signal intensity curve revealed an early strong contrast enhancement and a delayed washout pattern.

A Case of Malignant Fibrous Histiocytoma-like Sarcomatoid Metaplastic Carcinoma of the Breast

A metaplastic carcinoma of the breast (MpC) is a very rare malignant tumor accounting for fewer than 1% of all mammary tumors. MpCs are difficult to diagnose accurately and classify because of their rarity and varied histological patterns. A MpC is a histologically diverse type of malignancy in which an adenocarcinoma is found to co-exist with an admixture of spindle cells, squamous, chondroid, or bone-forming neoplastic cells. Cystic changes can be encountered in MpC, particularly in carcinoma with squamous metaplasia, but are rare in a sarcomatoid metaplastic carcinoma. We recently experienced an unusual case of a sarcomatoid metaplastic carcinoma mimicking a malignant fibrous histiocytoma of the soft tissue in a 34-year-old female, who had a breast tumor with an extensive cystic change, which was growing rapidly. Here, we report this unusual case of MpC with a review of the relevant literature.

Metaplastic Squamous Cell Carcinoma of the Breast

Metaplastic carcinomas of the breast are very rare malignancy and accounts for less than 1% of all mammary tumors. Metaplastic breast cancers are a highly heterogeneous group of neoplasms, where an adenocarcinoma is found to co-exist with an admixture of spindle, squamous and chondroid or bone-forming neoplastic cells. The degree of differentiation of metaplastic cells is also quite variable. Due to the rarity and highly heterogeneous nature of metaplastic breast cancer, there has been controversy regarding the nomenclature and classification of these neoplasms. Also there is little information on the treatment and prognosis of metaplastic breast cancer in the literature. A 75-year old woman presented with a rapidly-growing huge mass in the outer upper quadrant of her left breast of 5 months duration. The mass was a metaplastic squamous breast cancer. We report this case with a review of the literature.

The Clinicopathologic Characteristics of Metaplastic Carcinomas of the Breast

PURPOSE: Metaplastic carcinomas of the breast (MpC) are rare disease with little information. The goal of this study is to describe the clinicopathologic characteristics of MpC and to compare the prognosis of MpC with that of infiltrating ductal carcinoma (IDC). METHODS: Twenty-three patients who underwent surgery due to MpC at Seoul National University Hospital between May 1982 and February 2000 were retrospectively analyzed on the basis of medical records and pathologic reports. RESULTS: All patients were females and the mean age was 47.3 years. The mean tumor size was 4.0 cm (range 1.0~11.0 cm). Twenty-one patients were treated with mastectomy and the remaining 2 patients were treated with lumpectomy. Four patients had metastatic disease at presentation. Lymph node metastases were detected in 6 of 21 (28.6%) patients who underwent axillary dissection. Two of 11 patients (18.2%) were positive for ER and one of 10 patients (10.0%) was positive for PgR. Follow-up was possible for thirteen patients. The overall 5 and 10-year survival rates were 66.7% and 35.6%, respectively. Additionally, the 5 and 10-year disease-free survival rates were 63.3% and 33.8%, respectively. When comparing against the control patients with IDC, the group with MpC tended to have a more unfavorable prognosis. However, this data was not statistically significant. CONCLUSION: Although MpC showed less frequent lymph node metastasis, the overall and disease-free survival rates of MpC patients was not better than IDC patients. Therefore patients with MpC require closer follow-up for disease recurrence.

Sarcoma and Sarcomatous Metaplastic Carcinoma of the Breast / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Primary sarcoma and SMC (sarcomatous metaplastic carcinoma) of the breast are very rare tumors, accounting for less than 1% of all breast malignancies. There are many controversies concerning the biological characteristics, prognosis and optimal treatment of these tumors owing to the rarity of incidence. The aims of this study were to elucidate the clinicopathologic characteristics of these tumors and to assist in elucidating the optimal treatment plan for the disease. MATERIALS AND METHODS: 13 cases of primary sarcoma and 10 cases of SMC that had been treated at KCCH between 1984 and 2001 were retrospectively reviewed. Phyllodes tumors were excluded from our study. RESULTS: Among the 13 cases of primary sarcoma included, stromal sarcoma occurred in 5 cases, osteosarcoma in 3 cases, angiosarcoma in 3 cases and spindle cell sarcoma in 2 cases. The mean age of the patients with primary sarcoma and SMC was 39.7 years and 55.1 years respectively (p=0.002). When survival rates were compared according to histologic types, size of tumor, histologic grade, type of surgery and use of adjuvant therapy, both size of tumor (p=0.0256) and histologic grade (p=0.0197) were shown to be prognostic factors. CONCLUSION: There were no significantly different features between primary sarcoma and SMC in terms of biologic characteristics or survival rates, with the exception that patients with SMC were older than those with primary sarcoma. Histologic grade and size of tumor were significant prognostic factors of these tumors.

Case of a Spindle Cell Metaplastic Carcinoma of the Breast

A metaplastic carcinoma of the breast is a histologically diverse type of malignancy in which an adenocarcinoma is found to co-exist with an admixture of spindle cell, squamous, chondroid, or bone-forming neoplastic cells. Metaplastic breast cancer is rare and accounts for less than 1% of all mammary tumors. An adenocarcinoma with spindle cell metaplasia is one of the least often recognized variants of a metaplastic carcinoma. The clinical behavior of this variant of metaplastic carcinoma has not yet been clearly defined. Herein, we report a case of spindle cell metaplastic carcinoma of the breast. We also present a review of the literature.

Pseudosarcomatous Metaplastic Carcinoma of the Breast with Extensive Cystic Change: A case report

Metaplastic carcinomas (carcinomas with metaplasia) of the breast are difficult to accurately diagnose and classify because of their rarity and varied histologic patterns. Cystic change can be encountered in mammary carcinoma, especially in carcinoma with squamous metaplasia, but are rare in pseudosarcomatous metaplastic carcinoma. We recently experienced a case of pseduosarcomatous metaplastic carcinoma in a 69-year-old female who had an extensive cystic change in radiologic and histopathologic findings. The precise cell type that gives rise to metaplastic carcinomas remains uncertain. Immunohistochemical findings raised the possibility of the myoepithelial nature of the tumor.

Pathologic Analysis of Gallbladder Cancer by the Stage and Intestinal Metaplasia with the Diagnostic Significance of CEA and p53

Twenty cases of gallbladder cancers were examined using 5 mm stepwise tissue sections. We analyzed the clinicopathologic findings of the early (stage 1, II) and advanced carcinoma (stage III, IV, V) and those of carcinoma with or without metaplasia in the tumor. We also performed CEA and p53 immunohistochemical staining and compared their findings with those of normal mucosa and preneoplastic lesions. The results were as follow: 1) All of the early carcinomas (n=5) were incidentally diagnosed after the resection for the gallstone. They were compared to advanced carcinoma (n=15) in the absence of the lymphatic or angioinvasion, recurrence, metastasis and death. 2) Metaplastic and non-metaplastic carcinoma did not reveal any difference of the clinicopathologic findings except age distribution. 3) CEA and p53 were positive in preneoplastic and malignant lesions. The extent of staining was related to the degree of the atypia. From the above results, an early detection of gallbladder cancer is very important for the prognosis of the patients. Since preoperative diagnosis is difficult, thorough pathologic examination of routinely resected gallbladder is necessary for the early diagnosis. CEA and p53 immunohistochemical staining may be helpful in the differential diagnosis of non-neoplastic and neoplastic lesion of the gallbladder.

Fine Needle Aspiration Cytologic Findings of Metaplastic Carcinoma of the Breast: A Case Report / 대한세포병리학회지

Metaplastic carcinoma of the breast is a morphologically heterogenous group of neoplasms characterized by ductal adenocarcinoma with extensive squamous differentiation, a spindle-cell pattern of growth, and/or heterologous mesenchymal elements. We experienced a case of metaplastic carcinoma diagnosed by fine needle aspiration(FNA) and confirmed by radical mastectomy in a 46 year-old woman. The FNA cytologic findings included atypical squamous cells with kertinization lying singly and in clusters in a necrotic background. In addition, scattered spindle cells with pleomorphic large nuclei and prominent nucleoli were present in a hemorrhagic and necrotic background. The histopathologic findings showed moderately differentiated squamous cell carcinoma and highly pleomorphic sarcoma with chondroid component. The immunohistochemical stain revealed focal positive reaction for cytokeratin as well as diffuse reactivity for vimentin in the sarcomatous area.