Gabal S, Talaat S
Department of Pathology, Faculty of Medicine, Cairo University, Giza 12655, Egypt. ns
Int J Breast Cancer. 2011;2011:704657. doi: 10.4061/2011/704657. Epub 2011 Feb 6.
Secretory carcinoma is a rare low-grade breast carcinoma, initially termed "juvenile breast cancer," but it is now known to occur in adults of both sexes. It is the only epithelial tumor of the breast with a balanced translocation, t(12;15), that creates an ETV6-NTRK3 gene translocation. In this paper, a 19-year-old male patient has had a right breast mass for 9 years which suddenly increased in size with no evidence of palpable axillary lymph nodes. The mass was excised for frozen section and was diagnosed as malignant growth for simple mastectomy. Microscopic examination revealed the classical features of secretory carcinoma. The tumor cells were positive for EMA and S-100 protein and focally positive for cytokeratin and ER but negative for progesterone receptor, CD34, and CEA. Four months later the patient developed ipsilateral axillary lymph node enlargement, with lymph node metastases in five of the dissected 19 lymph nodes. The patient was treated with six courses of chemotherapy and radiotherapy. Conclusion. Though considered an indolent neoplasm, secretory carcinoma does metastasize to lymph nodes. Surgery in the form of mastectomy with axillary clearance is the treatment of choice. This paper includes a rare case report of secretory carcinoma in young male patient, with axillary lymph node metastasis in spite of the indolent nature that this tumor is known to display.
分泌性癌是一种罕见的低级别乳腺癌，最初被称为“青少年乳腺癌”，但现在已知在男女成年人中均可发生。它是乳腺唯一一种具有平衡易位t(12;15)的上皮性肿瘤，该易位产生ETV6-NTRK3基因易位。本文报道了一名19岁男性患者，右乳肿块9年，近期突然增大，未触及腋窝淋巴结。肿块切除后行冰冻切片检查，诊断为恶性肿瘤，遂行单纯乳房切除术。显微镜检查显示具有分泌性癌的典型特征。肿瘤细胞EMA和S-100蛋白阳性，细胞角蛋白和雌激素受体局灶阳性，但孕激素受体、CD34和癌胚抗原阴性。4个月后患者出现同侧腋窝淋巴结肿大，19枚切除淋巴结中有5枚发生淋巴结转移。患者接受了6个疗程的化疗和放疗。结论：尽管分泌性癌被认为是一种惰性肿瘤，但确实会发生淋巴结转移。以乳房切除加腋窝清扫术的形式进行手术是首选治疗方法。本文报道了一例年轻男性分泌性癌的罕见病例，尽管该肿瘤通常表现为惰性，但仍发生了腋窝淋巴结转移。
