Metaplastic Carcinoma with Chondroid Differentiation Arising in Microglandular Adenosis

김가언,이지신,김나임,박민호 대한병리학회 2017 Journal of Pathology and Translational Medicine Vol.51 No.4

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.

화생성 유방암의 영상 소견 : 증례 보고

정미희,정경순 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.4

Metaplastic carcinomas of the breast comprise a heterogeneous group of neoplasms that are regarded as a ductal carcinoma that undergos metaplasia into a nonglandular growth pattern. Metaplastic carcinoma is uncommon, accounting for fewer than 5% of breast carcinomas. It has a poorer prognosis than most other breast malignancies. We report the mammographic and sonographic findings in a 52-year-old woman of pathologically proven metaplastic carcinoma.

Metaplastic Breast Carcinoma: Case Series and Review of the Literature

Esbah, Onur,Turkoz, Fatma P.,Turker, Ibrahim,Durnali, Ayse,Ekinci, Ahmet S.,Bal, Oznur,Sonmez, Ozlem Uysal,Budakoglu, Burcin,Arslan, Ulku Y.,Oksuzoglu, Berna Asian Pacific Journal of Cancer Prevention 2012 Asian Pacific journal of cancer prevention Vol.13 No.9

Metaplastic breast carcinoma (MpBC) is a rare disease entity, accounting for less than 1% of all breast carcinomas. Furthermore, it is a heterogenous disease with different subgroups, including malignant epithelial (carcinoma) and stromal (sarcoma) features. Here we evaluated, retrospectively, 14 female MpBC patients admitted to Ankara Oncology Training and Research Hospital between 2005 and 2011. Median age was 45.5 (range:16.0-76.0) and tumor size 57.5 mm (range: 20.0-80.0 mm). Histopathological subtypes were as follows: 5 carcinosarcoma, 5 squamous and 4 adenosquamous carcinoma. All but one with upfront lung metastasis, had their primary breast tumor operated. Axillary lymph nodes were involved in 64.3%. The most common sites of metastasis were lungs and brain. Chemotherapy including antracycline, taxane and even platinium was planned for adjuvant, neoadjuvant and palliative purposes in 9, 3 and 1 patient, respectively. Median cycles of chemotherapy was 6 (range:4-8). Median follow-up of the patients was 52 months (95%CI 10.4-93.6 month). Median 3 year progression free survival (PFS) and overall survival (OS) in this patients cohort were 33% and 56%, respectively. In conclusion, MpBC is a rare and orphan disease without standardized treatment approaches and the prognosis is poor so that larger studies to investigate different treatment schedules are urgently needed.

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

조은윤,김지연,김태은 대한병리학회 2010 Journal of Pathology and Translational Medicine Vol.44 No.6

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 “asal-like”phenotype and frequent expressions of CAV-1 and VEGF may justify specific therapeutic approaches.

Molecular Classification of Metaplastic Carcinoma Using Surrogate Immunohistochemical Staining

Kim, Hye Min,Kim, Do Hee,Jung, Woo Hee,Koo, Ja Seung S. Karger AG 2014 Pathobiology Vol.81 No.2

<P>Abstract</P><P><B><I>Objective:</I></B> The purpose of this study is to investigate molecular subtyping and its implications on metaplastic carcinoma according to surrogate immunohistochemical (IHC) staining. <B><I>Methods:</I></B> Following tissue microarray analysis of 34 cases of metaplastic carcinoma, IHC staining for cytokeratin (CK) 5/6, epidermal growth factor receptor (EGFR), claudin-3, claudin-4, claudin-7, E-cadherin, STAT-1, androgen receptor and GGT was performed and classified into basal-like, molecular apocrine, claudin-low, immune-related, mixed and null types. <B><I>Results:</I></B> Among the 34 cases of metaplastic carcinoma, 13 were of the basal-like type (35.2%), 9 of the mixed type (26.5%), 8 of the null type (23.5%), 3 of the claudin-low type (8.8%), and 1 was of the molecular apocrine type (2.9%). Depending on the cell type, there were differences between molecular subtypes, with the matrix-producing type occupying the largest proportion in the basal-like, null and mixed types. The spindle cell type represented the largest proportion in the claudin-low and molecular apocrine types, and the squamous cell type characterized the largest proportion in the basal-like type. <B><I>Conclusion:</I></B> Following molecular subtyping of metaplastic carcinomas using surrogate IHC markers, the largest number of cases was of the basal-like type, followed by the mixed, null, claudin-low and molecular apocrine types. There were differences between molecular subtypes according to the cell type.</P><P>© 2013 S. Karger AG, Basel</P>

Metaplastic Carcinoma with an Adenomyoepithelioma Component : A Case Report

연진선,최보배,서광선,엄준영 대한초음파의학회 2012 ULTRASONOGRAPHY Vol.31 No.2

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.

유방에 발생한 화생성 암종의 세침흡인 세포학적 소견 - 1증례 보고 -

민수기,차희정,김준미,주영채,Min, Soo-Kee,Cha, Hee-Jeung,Kim, Joon-Mee,Chu, Young-Chae 대한세포병리학회 1996 대한세포병리학회지 Vol.7 No.2

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 tying 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.

육종형 화생성 유방암: 증례 보고

김혜정,최선형,정수영,양익,신미경 대한초음파의학회 2010 ULTRASONOGRAPHY Vol.29 No.3

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. 화생성 유방암은 드문 침윤성 유방암으로 편평상피형,육종형, 방추세포형, 기질생성형 등의 다양한 화생을 동반하는 질환이다. 대부분이 편평상피형 혹은 방추세포형이며육종형 화생은 매우 드물며 이에 대한 영상 소견을 포함한증례도 드물다. 이에 저자들은 최근 초음파 영상 검사에서비교적 경계가 분명한 둥근 모양의 저에코 종괴로 보인 육종형 화생성 유방암 1예를 경험하였기에 보고한다.

담낭암의 병기 및 장형화생에 따른 병리학적 분석과 CEA, p53의 진단적 의의

장희진,서정일 대한병리학회 1997 Journal of Pathology and Translational Medicine Vol.31 No.7

이형성 유방암의 자기공명영상소견: 증례 보고

임수아,김학희,한송이,이연수 대한영상의학회 2004 대한영상의학회지 Vol.50 No.4

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. 저자들은 이형성 유방암의 자기공명영상소견을 보고하고자 한다. 44세 여자환자가 우측유방에 2개월 전부터 종괴가 만져져서 내원하였다. 유방 자기공명영상검사에서 종양 내부에 불규칙한 모양의 T1 강조영상에서 저신호강도, T2 강조영상에서 고신호강도를 보이는 괴사성 혹은 낭성변형을 나타 내었으며 종양변연부는 조영증강 후 영상에서 강하게 조영증강이 되는 소견을 나타내었다. 시간-신호강도 커브는 조 기에 강하게 조영 증강이 되고 서서히 조영제가 빠져나가는 양상을 보여 악성임을 시사하였다.