Liu Xibo, Chen Jiahui, Hou Chuanling
Department of Pathology, Shaoxing People's Hospital, No. 568, Zhongxing North Road, Shaoxing, 312000, Zhejiang, China.
Discov Oncol. 2024 Apr 1;15(1):93. doi: 10.1007/s12672-024-00958-6.
Squamous cell carcinoma (SCC) of the breast is a rare variant of invasive breast cancer that has been classified as metaplastic carcinoma. When a tumor is composed of spindle cells, diagnosis is challenging.
A 42-year-old woman with a large mass in the right breast underwent modified radical mastectomy. A pathological examination revealed a tumor with central necrosis in it. The tumor had a sarcomatoid growth pattern and the cells were spindle-shaped with severe atypicality. Immunohistochemical staining showed that P63, P53, vimentin, and CKpan were positive, whereas estrogen receptor and C-erbB-2 were negative. Ki-67 proliferation index was as high as 90%. Therefore, a diagnosis of SCC of the right breast was made. The patient received eight cycles of postoperative chemotherapy with paclitaxel and carboplatin, followed by seven cycles of radiotherapy. During follow-up, the patient also had a left thyroid tumor, and postoperative pathology suggested microinvasive follicular carcinoma. Since breast surgery, the patient has remained disease-free for more than four years.
SCC of the breast with spindle cell and sarcomatoid features is rare. The diagnosis of such tumors requires exclusion of tumors with similar histological morphologies.
乳腺鳞状细胞癌（SCC）是浸润性乳腺癌的一种罕见变异型，已被归类为化生性癌。当肿瘤由梭形细胞组成时，诊断具有挑战性。
一名42岁的女性，右乳有一个大肿块，接受了改良根治性乳房切除术。病理检查显示肿瘤内有中央坏死。肿瘤呈肉瘤样生长模式，细胞呈梭形，具有严重的异型性。免疫组化染色显示P63、P53、波形蛋白和细胞角蛋白（CKpan）呈阳性，而雌激素受体和C-erbB-2呈阴性。Ki-67增殖指数高达90%。因此，诊断为右乳鳞状细胞癌。患者接受了8个周期的紫杉醇和卡铂术后化疗，随后进行了7个周期的放疗。在随访期间，患者还患有左侧甲状腺肿瘤，术后病理提示微浸润性滤泡癌。自乳房手术以来，患者已无病生存超过四年。
具有梭形细胞和肉瘤样特征的乳腺鳞状细胞癌罕见。此类肿瘤的诊断需要排除具有相似组织形态学的肿瘤。
