Emory School of Medicine, Emory University, Atlanta, Georgia, USA.
Department of Dermatology, Emory University, Atlanta, Georgia, USA.
J Cutan Pathol. 2020 Dec;47(12):1187-1191. doi: 10.1111/cup.13822. Epub 2020 Sep 14.
We present a case detailing a 70-year-old female with a history of triple-negative breast carcinoma (TNBC) of the left breast and contralateral stage pT2a nodular melanoma of the right upper arm who underwent sentinel lymph node biopsy of the right axilla demonstrating a metastatic epithelioid tumor that was strongly positive for S-100 protein and SOX10. The tumor cells were negative for HMB-45 and Melan-A and positive for CK7 and other breast markers (GCDFP15, mammaglobin, and GATA3). While concerning for metastatic melanoma based on clinical history and initial immunohistochemistry, tumor morphology and subsequent immunohistochemistry was supportive of metastatic breast adenocarcinoma. This case demonstrates a rare but perilous diagnostic pitfall of triple-negative breast carcinomas that strongly and diffusely express S-100 protein and SOX10 mimicking melanoma.
我们呈现了一个病例细节，患者为 70 岁女性，左乳三阴性乳腺癌（TNBC），右侧上臂节段 pT2a 结节性黑色素瘤，行右侧腋窝前哨淋巴结活检，显示转移性上皮样肿瘤，S-100 蛋白和 SOX10 强阳性。肿瘤细胞 HMB-45 和 Melan-A 阴性，CK7 和其他乳腺标志物（GCDFP15、乳球蛋白和 GATA3）阳性。虽然根据临床病史和初始免疫组化检查结果考虑为转移性黑色素瘤，但肿瘤形态和随后的免疫组化检查结果支持转移性乳腺腺癌。该病例展示了三阴性乳腺癌的一种罕见但危险的诊断陷阱，其强烈和弥漫性表达 S-100 蛋白和 SOX10，类似于黑色素瘤。
