Cystic hypersecretory carcinoma with invasion: Case series on a rare variant of carcinoma breast

Background: Cystic Hypersecretory Carcinoma (CHC) is a rare subset of breast carcinoma. It is part of a spectrum of cystic hypersecretory lesions which includes cystic hypersecretory hyperplasia (CHH), CHH with atypia, CHC in situ and CHC with invasion. Approximately 65 cases of cystic hypersecretory lesions have been reported; most of them were CHC in situ and only 19 cases of CHC with invasion have been reported so far. Case Presentation: We are reporting 2 cases of 47 and 62 year old women with a palpable breast mass for 6 and 1 month duration respectively. Trucut biopsy was carried out for both which showed high grade ductal carcinoma in situ with microinvasion in the first patient and the latter showed a tiny focus of invasive carcinoma. Simple mastectomy and modified radical mastectomy (MRM) were done for the respective cases; both showed dilated cystic spaces filled with eosinophilic secretions (thyroid colloid-like), lining neoplastic cells that showed variable degrees of proliferation, atypia and in situ carcinoma. There were foci of invasion in both cases and hence a morphological diagnosis of CHC with invasion was made. Conclusion: Owing to a smaller number of reported cases, little is known about the biological behavior, prognosis and molecular profile of cystic hypersecretory carcinoma.

Diagnosis and treatment of cystic hypersecretory carcinoma of the breast / 中华内分泌外科杂志

Cystic hypersecretory carcinoma of the breast is very rare, and has a special histological morphology and immunophenotype. It was understood that it cannot be misdiagnosed as invasive carcinoma of the breast or other benign lesions. This paper reports a case of this tumor treated in our hospital on Apr. 2, 2011. The clinical data, ultrasonic manifestations, histomorphology and immunophenotype were analyzed retrospectively. This study aims to investigate the clinicopathological, immunohistochemistry, diagnosis and prognosis of cystic hypersecretory carcinoma of the breast, so as to improve clinicians’further understanding of it.

Invasive Cystic Hypersecretory Carcinoma of the Breast: A Case Report

Cystic hypersecretory lesions of the breast are rare. These breast lesions include cystic hypersecretory hyperplasia (CHH), atypical CHH, and cystic hypersecretory carcinoma (CHC). The characteristic features are dilated ducts and cysts filled with thyroid colloid-like eosinophilic secretion. Only seven cases of invasive CHC have been reported in the literature. Here, we report an additional case of invasive CHC. The histologic features of the tumor showed both micropapillary intraductal carcinoma and focal high-grade invasive carcinoma in a background of CHH. This case suggests that cystic hypersecretory breast lesions encompass a spectrum of pathologic lesions including CHH, atypical CHH, CHC, and invasive CHC.

Fine Needle Aspiration Cytology of Cystic Hypersecretory Intraductal Carcinoma of the Breast: Report of Two Cases / 대한세포병리학회지

Cystic hypersecretory carcinoma of the breast is a rare variant of ductal carcinoma of breast, first described in 1984 by Rosen and Scott. Histologically, it is characterized by the formation of dilated ducts and cysts containing an eosinophilic secretory product resembling thyroid colloid. Cytologic findings show a few clusters of atypical ductal epithelial cells in amorphous proteinaceous material with cracking artifact. Differential diagnosis include mucinous carcinoma and benign mucocele-like tumor. We present two cases of fine needle aspiration cytology of cystic hypersecretory intraductal carcinoma of the breast with a review of the literature.

Case of a Cystic Hypersecretory Duct Carcinoma of the Breast

Breast cystic hypersecretory duct carcinomas (CHDC), characterized by cystic dilatation of ducts, cysts filled with thyroid colloid-like eosinophilic material, and by micropapillary carcinomas in the epithelium lining the cyst, is a rare histological variant of intraductal carcinomas. CHDC is differentiated from cystic hypersecretory hyperplasia. It's clinical manifestations are similar to those of other intraductal carcinomas. CHDC has a low-grade behavior for many years, but can be invasive, with the potential for metastasis. The importance of CHDC is its differentiation from a variety of other lesions of the breast, both benign and malignant. Various differential diagnoses for CHDC include: fibrocystic changes of the breast with microcyst formation, juvenile papillomatosis, benign mucocele-like lesions, juvenile secretory carcinomas, mucin-producing colloid carcinomas and metastatic follicular thyroid carcinomas. Histochemical staining (PAS, alcian blue and mucicarmine) or immunoperoxidase studies (CEA, alpha-lactalbumin and thyroglobulin) may also helpful in differential diagnoses. We report a case of a cystic hypersecretory duct carcinoma (CHDC) of the breast, and present a review of the literature.