Akanchha Kujur Shipha, Tirkey Deepali, Singh Deepanshu, Banerjee Saurav, Ashok Chanchal
Pathology, Rajendra Institute of Medical Sciences, Ranchi, IND.
Cureus. 2024 Jul 2;16(7):e63717. doi: 10.7759/cureus.63717. eCollection 2024 Jul.
Metaplastic breast cancer represents a very rare and histopathologically diverse subtype of breast cancer. It shows neoplastic epithelial differentiation into squamous cells and/or mesenchymal-like components, resulting in its aggressive behavior and poor prognosis compared to other types of breast cancer. Here, we describe the case of a 43-year-old woman diagnosed with metaplastic carcinoma of the breast who presented like any other case of breast lump in the right breast for six months. The tumor had a large size with an ulcerative lesion of the breast. Ultrasound showed heterogeneous echogenicity and lymph node involvement. Surgical resection with axillary lymph node dissection was done. The microscopic examination after tissue processing showed highly pleomorphic tumor cells along with chondromyxoid stroma and osseous differentiation, suggestive of metaplastic breast cancer which was triple-negative for estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 on immunohistochemistry. The axillary lymph nodes identified were negative for tumor cells. The rarity and aggressive nature of this cancer pose diagnostic challenges and highlight the importance of multidisciplinary approaches for effective management.
化生性乳腺癌是一种非常罕见且组织病理学表现多样的乳腺癌亚型。它表现为肿瘤性上皮细胞分化为鳞状细胞和/或间充质样成分，与其他类型的乳腺癌相比，其具有侵袭性且预后较差。在此，我们描述了一例43岁被诊断为化生性乳腺癌的女性病例，该患者右乳出现乳腺肿块症状达6个月，与其他乳腺肿块病例无异。肿瘤体积较大，伴有乳腺溃疡性病变。超声显示回声不均匀且有淋巴结受累。进行了手术切除及腋窝淋巴结清扫。组织处理后的显微镜检查显示肿瘤细胞高度多形性，伴有软骨黏液样基质和骨分化，提示为化生性乳腺癌，免疫组化显示雌激素受体、孕激素受体和人表皮生长因子受体2均为三阴性。所识别的腋窝淋巴结未见肿瘤细胞。这种癌症的罕见性和侵袭性给诊断带来了挑战，并凸显了多学科方法对有效管理的重要性。
