Neelamraju Lakshmi Harish, Saini Devendra, Om Prabha, Verma Naveen
General Surgery, Sawai Man Singh Medical College, Jaipur, IND.
Cureus. 2020 Aug 28;12(8):e10104. doi: 10.7759/cureus.10104.
Carcinosarcoma, also known as metaplastic carcinoma, is a rare and aggressive malignant tumor. We report a case of metaplastic carcinoma presenting as inflammatory carcinoma and provide a review of the related literature. A 38-year-old breastfeeding woman presented with concerns about a painful lump in her left breast. The symptoms had been present for two months. After admission to the hospital, the triple assessment revealed findings consistent with inflammatory carcinoma of the breast. The patient underwent modified radical mastectomy. Histopathological examination revealed a gray-white tumor with a biphasic pattern with features of ductal carcinoma as well as squamous and sarcomatous differentiation. On immunohistochemistry, the neoplastic cells were positive for cytokeratin and vimentin, and focally positive for smooth muscle antigen (SMA) and negative for estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor (HER-2/neu). Based on histological and immunohistochemical findings, the tumor was diagnosed as carcinosarcoma. Four of eighteen dissected axillary lymph nodes were positive for metastasis. Carcinosarcoma is often a triple-negative tumor. The lack of standardized treatment protocols frequently leads to poor prognosis and can pose a diagnostic dilemma; it should be part of the differential diagnosis for a case of carcinoma of the breast presenting as inflammatory carcinoma.
癌肉瘤，也称为化生性癌，是一种罕见且侵袭性强的恶性肿瘤。我们报告一例表现为炎性癌的化生性癌病例，并对相关文献进行综述。一名38岁的哺乳期女性因左乳疼痛性肿块前来就诊。症状已持续两个月。入院后，三联评估显示结果与乳腺炎性癌相符。患者接受了改良根治性乳房切除术。组织病理学检查显示为灰白色肿瘤，具有双相模式，兼具导管癌特征以及鳞状和肉瘤样分化。免疫组化检查显示，肿瘤细胞细胞角蛋白和波形蛋白呈阳性，平滑肌抗原（SMA）局灶性阳性，雌激素受体（ER）、孕激素受体（PR）和人表皮生长因子受体（HER-2/neu）呈阴性。根据组织学和免疫组化结果，该肿瘤被诊断为癌肉瘤。18个切除的腋窝淋巴结中有4个出现转移阳性。癌肉瘤通常是三阴性肿瘤。缺乏标准化的治疗方案常常导致预后不良，并且可能造成诊断困境；对于表现为炎性癌的乳腺癌病例，它应作为鉴别诊断的一部分。
