de Alencar Natália Nobre, de Souza Diego Agra, Lourenço Alexandre Alves, da Silva Raimunda Ribeiro
Universidade Federal do Maranhão (UFMA), Hospital Universitário, São Luís, MA, Brasil.
Hospital do Câncer Aldenora Bello, Laboratório de Patologia, São Luís, MA, Brasil.
Autops Case Rep. 2022 Apr 14;12:e2021365. doi: 10.4322/acr.2021.365. eCollection 2022.
Breast sebaceous carcinoma is one of the rarest breast neoplasms, with less than 30 cases reported worldwide. Due to the rarity, the new WHO classification of breast tumors grouped these tumors among the ductal carcinoma. A detailed description of these cases is relevant due to the insufficient knowledge about the prognosis of this neoplasm. We report the clinical, histological, and immunohistochemical characteristics of a case of sebaceous carcinoma of the breast in an 81-year-old woman with a right breast nodule. The tumor was composed of nests of a varying mixture of sebaceous cells with abundant slightly vacuolated cytoplasm, surrounded by smaller oval-to-fusiform cells with eosinophilic cytoplasm without vacuolization. No lymph node metastases were present. The immunohistochemical reactions were positive for GATA3, EMA, CD15, and GCDFP15 (focal staining), and negative for RE, RP, and HER-2. The tumor was classified as triple-negative. Morphologically, the differential diagnoses included skin sebaceous carcinoma, lipid-rich carcinoma, apocrine carcinoma, and glycogen-rich clear cell carcinoma. Most of the previously reported cases were positive for RE and RP, which generally was associated with a better prognosis. However, some cases presented a more aggressive behavior with distant and lymph node metastases.
乳腺皮脂腺癌是最罕见的乳腺肿瘤之一,全球报道的病例不足30例。由于其罕见性,世界卫生组织新的乳腺肿瘤分类将这些肿瘤归为导管癌。鉴于对该肿瘤预后的了解不足,对这些病例进行详细描述具有重要意义。我们报告了一名81岁患有右乳结节的女性乳腺皮脂腺癌病例的临床、组织学和免疫组化特征。肿瘤由巢状排列的皮脂腺细胞组成,这些细胞混合多样,胞质丰富且略呈空泡状,周围是较小的椭圆形至梭形细胞,胞质嗜酸性,无空泡化。无淋巴结转移。免疫组化反应显示GATA3、EMA、CD15和GCDFP15呈阳性(局灶性染色),RE、RP和HER-2呈阴性。该肿瘤被分类为三阴性。形态学上,鉴别诊断包括皮肤皮脂腺癌、富含脂质癌、大汗腺癌和富含糖原的透明细胞癌。大多数先前报道的病例RE和RP呈阳性,这通常与较好的预后相关。然而,一些病例表现出更具侵袭性的行为,出现远处转移和淋巴结转移。