Houissa Ines, Houcine Yoldez, Hmidi Amira, Bouaziz Hanène, Dieb Tarek, Driss Maha
Surgical Department, Salah Azeiz Institute, Tunis, Tunisia; Faculty of Medicine of Tunis, El Manar University, Tunis, Tunisia.
Immuno-cyto-histology Department, Salah Azeiz Institute, Tunis, Tunisia; Faculty of Medicine of Tunis, El Manar University, Tunis, Tunisia.
Int J Surg Case Rep. 2024 Nov;124:110444. doi: 10.1016/j.ijscr.2024.110444. Epub 2024 Oct 13.
Tall cell carcinoma of the breast with reverse polarity (TCCRP) is a recently described rare entity with low potential for malignancy which exhibits morphological features with tall cell variant of papillary thyroid carcinoma. Immunohistochemical and molecular studies help establish the diagnosis.
We report the case of a 45-year-old woman with no significant medical or surgical history who presented with mastodynia. Physical examination was negative. Screening by bilateral mammography revealed a mass of the right breast which was classified as 4B. The mass was surgically excised. The pathological report concluded to a TCCRP of the breast with free margins. The tumor cells were negative for hormone receptors as well as for the Human Epidermal Growth Factor Receptor-2 (HER2neu). The patient underwent a sentinel lymph node dissection that was negative followed by loco-regional radiotherapy. Chemotherapy and endocrine therapy were not indicated for the patient. After 24 months of follow-up, no signs of loco-regional or distant recurrences have been identified.
TCCRP is a rare entity that has been recently introduced in the WHO classification of breast cancer. It is usually a triple negative tumor, negative to TTF1 and thyroglobulin with low proliferation index, and a low potential for malignancy. Wide excision is the keystone of the treatment; however, chemotherapy and radiotherapy are still controversial due to lack of evidence.
TCCRP is a rare entity, which carries an excellent prognosis. A proper diagnosis is essential to conduct the best treatment next to a careful follow-up due to the ambiguous natural history of this rare entity.
None.
具有反向极性的乳腺高细胞癌（TCCRP）是一种最近描述的罕见实体，恶性潜能低，具有甲状腺乳头状癌高细胞变体的形态学特征。免疫组织化学和分子研究有助于确诊。
我们报告一例45岁女性，无重大内科或外科病史，因乳房疼痛就诊。体格检查阴性。双侧乳腺钼靶筛查发现右乳有一肿块，分类为4B。该肿块经手术切除。病理报告诊断为乳腺TCCRP，切缘阴性。肿瘤细胞激素受体及人表皮生长因子受体2（HER2neu）均为阴性。患者接受了前哨淋巴结清扫，结果为阴性，随后进行了局部区域放疗。该患者未行化疗及内分泌治疗。随访24个月后，未发现局部区域或远处复发迹象。
TCCRP是一种罕见实体，最近被纳入世界卫生组织乳腺癌分类。它通常是三阴性肿瘤，TTF1和甲状腺球蛋白阴性，增殖指数低，恶性潜能低。广泛切除是治疗的关键；然而，由于缺乏证据，化疗和放疗仍存在争议。
TCCRP是一种罕见实体，预后良好。由于这种罕见实体的自然病史不明确，正确诊断对于在仔细随访的同时进行最佳治疗至关重要。
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