Bhagwandeen B S, Fenton L
University of Newcastle, New South Wales, Australia.
Pathology. 1999 May;31(2):166-8. doi: 10.1080/003130299105386.
Carcinoma of the breast is very rare in childhood and is exceedingly rare in boys. Secretory carcinoma, a distinctive and rare variant of breast carcinoma is for some unknown reason the commonest type seen in children. To our knowledge there have been only four previous reports in boys under ten years old. We report the first case in Australia of this unusual tumor in a nine year old boy. The child presented with a subareolar nodule 12 mm in its greatest dimension. High resolution sonography showed a well defined hypoechoic nodule. Histology revealed classical features of secretory carcinoma with circumscribed, pushing margins, except for one site of invasion. The tumor displayed the typical cribriform and microcystic pattern with PAS positive, diastase resistant secretions, and lack of pleomorphism and mitotic activity. Tumor cells showed positive staining with S100 and polyclonal CEA and negative staining for estrogen and progesterone receptors. Although, because of its rarity, the natural history of this tumor is not well documented and optimal management is uncertain, prognosis happens to be excellent as these tumors behave in an indolent manner, both in children and in adults.
乳腺癌在儿童时期非常罕见，在男孩中更是极为罕见。分泌性癌是乳腺癌一种独特且罕见的变体，不知为何却是儿童中最常见的类型。据我们所知，此前仅有4例10岁以下男孩的相关报道。我们报告澳大利亚首例9岁男孩患这种罕见肿瘤的病例。该患儿表现为乳晕下结节，最大直径为12毫米。高分辨率超声显示为边界清晰的低回声结节。组织学检查显示为分泌性癌的典型特征，边界清晰，呈推挤状边缘，但有一处浸润部位。肿瘤呈现典型的筛状和微囊状结构，分泌物PAS阳性、淀粉酶抵抗，且无多形性和有丝分裂活性。肿瘤细胞S100和多克隆CEA染色呈阳性，雌激素和孕激素受体染色呈阴性。尽管由于其罕见性，该肿瘤的自然病程记录不完善，最佳治疗方案也不确定，但这些肿瘤在儿童和成人中均表现为惰性，预后恰好极佳。
