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Indian Journal of Dermatology 2024Primary cutaneous carcinosarcoma (PCCS) is a rare cutaneous biphasic tumour with just 120 cases being reported till date. The epithelial component trichoblastic...
Primary cutaneous carcinosarcoma (PCCS) is a rare cutaneous biphasic tumour with just 120 cases being reported till date. The epithelial component trichoblastic carcinoma/ malignant trichoblastoma (trichoblastic carcinosarcoma) is even rarer, so is the present case. An eighty years old male patient presented with a rapidly progressing ulceroproliferative nodular growth on the left temporal region. The incisional biopsy showed primary cutaneous carcinomasarcoma (PCCS). IHC showed epithelial and stromal component marked exclusively for pancytokeratin (AE1/AE3) CK5&6/ p40 and vimentin respectively. Both components were immunopositive for D2-40 and immunonegative for BerEP4/ S100/ Melan A/ MITF, thus final diagnosis given was Trichoblastic carcinosarcoma. Wide excision of the lesion with local rotation flap and skin grafting (thigh skin) was done. Patient remains disease free after four years also. Present case thus highlights the importance of HPE, IHC and early surgery for excellent prognosis of PCCS.
PubMed: 38572039
DOI: 10.4103/ijd.ijd_243_23 -
Discover Oncology Apr 2024Metaplastic breast carcinoma (MBC), a category of breast cancer, includes different histological types, which are occasionally mixed and heterogeneous. Considering the...
Immunohistochemical and molecular profiles of heterogeneous components of metaplastic breast cancer: a squamous cell carcinomatous component was distinct from a spindle cell carcinomatous component.
Metaplastic breast carcinoma (MBC), a category of breast cancer, includes different histological types, which are occasionally mixed and heterogeneous. Considering the heterogeneity of cancer cells in a tumour mass has become highly significant, not only from a biological aspect but also for clinical management of recurrence. This study aimed to analyse the immunohistochemical and molecular profiles of each MBC component of a tumour mass. Twenty-five MBC tumours were histologically evaluated, and the most frequent MBC component (c) was squamous cell carcinoma (SCC), followed by spindle cell carcinoma (SpCC). A total of 69 components of MBC and non-MBC in formalin-fixed paraffin-embedded sections were examined for 7 markers by immunohistochemistry. SCC(c) were significantly PTEN negative and CK14 positive, and SpCC(c) were significantly E-cadherin negative and vimentin positive. Multivariate analyses revealed that immunohistochemical profiles of normal/intraductal (IC)(c), no special type (NST)(c), and MBC(c) differed; moreover, SCC(c) and SpCC(c) were distinctly grouped. PTEN gene mutation was detected only in SCC(c) (2/7), but not in SpCC(c). Next-generation sequence analyses for 2 cases with tumours containing SCC(c) demonstrated that PTEN gene mutation increased progressively from IC(c) to NST(c) to SCC(c). In conclusion, the immunohistochemical and molecular profiles of the SCC(c) of MBC are distinct from those of the SpCC(c).
PubMed: 38564036
DOI: 10.1007/s12672-024-00950-0 -
Discover Oncology Apr 2024Squamous 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...
INTRODUCTION
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.
CASE REPORT
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.
CONCLUSION
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.
PubMed: 38558111
DOI: 10.1007/s12672-024-00958-6 -
Oncology Letters May 2024Metaplastic breast cancer (BC-Mp), which includes a range of epithelial and mixed epithelial-mesenchymal tumours, are rare malignancies with an unfavourable prognosis....
Metaplastic breast cancer (BC-Mp), which includes a range of epithelial and mixed epithelial-mesenchymal tumours, are rare malignancies with an unfavourable prognosis. The limited literature on BC-Mp focuses mainly on retrospective data for radically treated patients. Notably absent are studies dedicated to the palliative treatment of BC-Mp with distant metastases. The present retrospective study investigated treatment modalities and prognosis in a multi-centre cohort of 31 female participants diagnosed with distant metastatic BC-Mp, including 7 patients with metastatic disease. The median age of the patients was 61 years (range, 33-87 years), with 38.7% presenting local lymph node involvement. Lungs were the most common site for the metastatic disease (61.3%). Median Ki-67 index was 50% (range, 35-70%), and 80.7% of cases were classified as grade 3. Human epidermal growth factor receptor 2 (HER2) and estrogen receptor were detected in 12.9 and 6.5% of cases, respectively. A total of 62.4% of patients received first-line palliative systemic treatment. The 1- and 2-year overall survival (OS) were 38.5 and 19.2%, respectively. Receiving ≥1 line of palliative treatment was significantly associated with improved OS (P<0.001). Factors such as age, Ki-67 index, HER2 or hormonal status, presence of specific epithelial or mesenchymal components, location of metastases or chemotherapy regimen type did not influence OS. The present study provided insights into the clinicopathological profile, systemic treatment experience, prognostic factors and OS data of BC-Mp with distant metastases, emphasizing the imperative for clinical trials in this population.
PubMed: 38516685
DOI: 10.3892/ol.2024.14331 -
Medical Archives (Sarajevo, Bosnia and... 2024Metaplastic breast cancer is a clinically rare subtype of breast carcinomas, accounting for less than 1% of all breast neoplasms, and was not officially recognized till... (Review)
Review
BACKGROUND
Metaplastic breast cancer is a clinically rare subtype of breast carcinomas, accounting for less than 1% of all breast neoplasms, and was not officially recognized till the end of the 20th century as an independent pathological diagnosis.
OBJECTIVE
In this paper, we report a case of metaplastic breast cancer with squamous differentiation in a 51-year-old female, with a succinct review of the literature.
CASE REPORT
The patient presented to our outpatient department with a complaint of left breast mass for 2 months duration with a diagnostic workup found to be grade three metaplastic carcinoma with squamous differentiation. The management decision was to proceed with neoadjuvant chemotherapy, followed by surgical intervention based on the tumor cell response to neoadjuvant therapy.
CONCLUSION
Metaplastic breast cancer represents a rare clinical entity, encountered in a minority of patients. The clinical presentation of metaplastic carcinomas in general is similar to other breast cancers, however, metaplastic breast cancer tend to present in later stages as a rapidly growing mass with poor prognosis. The recognized poor prognosis along with rarity necessities having a high index of suspicion for early detection and appropriate management of metaplastic breast cancer.
Topics: Female; Humans; Middle Aged; Breast Neoplasms; Metaplasia; Neoadjuvant Therapy; Carcinoma, Squamous Cell
PubMed: 38481595
DOI: 10.5455/medarh.2024.78.75-77 -
Frontiers in Pharmacology 2024Breast squamous cell carcinoma (SCC) is an uncommon and highly aggressive variant of metaplastic breast cancer. Despite its rarity, there is currently no consensus on...
Breast squamous cell carcinoma (SCC) is an uncommon and highly aggressive variant of metaplastic breast cancer. Despite its rarity, there is currently no consensus on treatment guidelines for this specific subtype. Previous studies have demonstrated that chemotherapy alone has limited efficacy in treating breast SCC. However, the potential for targeted therapy in combination with chemotherapy holds promise for future treatment options. In this case report, we present a patient with advanced HER2-positive breast SCC, exhibiting a prominent breast mass, localized ulcers, and metastases in the lungs and brain. Our treatment approach involved the administration of HER2-targeted drugs in conjunction with paclitaxel, resulting in a sustained control of tumor growth. This case represents a rare occurrence of HER2-positive breast SCC, with limited available data on the efficacy of previous HER2-targeted drugs in treating such patients. Our study presents the first application of HER2-targeted drugs in this particular case, offering novel therapeutic insights for future considerations. Additionally, it is imperative to conduct further investigations to assess the feasibility of treatment options in a larger cohort of patients.
PubMed: 38455963
DOI: 10.3389/fphar.2024.1332574 -
Cancer Reports (Hoboken, N.J.) Mar 2024Metaplastic Breast Cancer (MpBC) is an exceedingly rare entity, accounting for less than 1% of all malignant breast tumours. Predominantly triple-negative, they are...
BACKGROUND
Metaplastic Breast Cancer (MpBC) is an exceedingly rare entity, accounting for less than 1% of all malignant breast tumours. Predominantly triple-negative, they are notorious for their chemoresistance, high rates of recurrence and decreased disease-free survival (DFS). All this contributes significantly to BC mortality and results in poor prognostic implications. Limited evidence has led to a lacuna of specific treatment guidelines for this entity and hence remains an uncharted territory for clinicians.
CASE
We report a case of a 46 year old premenopausal female with left-sided metaplastic triple negative T3N2aM0 BC with mesenchymal differentiation (high grade) whom we treated with neoadjuvant chemotherapy, primary surgery in the form of extreme oncoplasty and adjuvant radiotherapy by Telecobalt machine. Contrary to the expected aggressive course of the disease and poor prognosis of treatment, the patient is presently in remission without progression for over 2 years of follow up.
CONCLUSION
Limited experience in management of this pathological entity warrants the need for more research on it, with a special focus on targeted therapy. Discussing possibilities of a tailored approach, rather than a one-size-fits-all approach may aid in paving the path for the future of MpBC treatment.
Topics: Female; Humans; Middle Aged; Precision Medicine; Breast Neoplasms; Prognosis; Carcinoma, Squamous Cell; Disease-Free Survival
PubMed: 38421154
DOI: 10.1002/cnr2.1997 -
BioRxiv : the Preprint Server For... Apr 2024Pancreatic ductal adenocarcinoma (PDA) is partly initiated through the transdifferentiation of acinar cells to metaplastic ducts that act as precursors of neoplasia and...
Pancreatic ductal adenocarcinoma (PDA) is partly initiated through the transdifferentiation of acinar cells to metaplastic ducts that act as precursors of neoplasia and cancer. Tuft cells are solitary chemosensory cells not found in the normal pancreas but arise in metaplasia and neoplasia, diminishing as neoplastic lesions progress to carcinoma. Metaplastic tuft cells (mTCs) function to suppress tumor progression through communication with the tumor microenvironment, but their fate during progression is unknown. To determine the fate of mTCs during PDA progression, we have created a lineage tracing model that uses a tamoxifen-inducible tuft-cell specific Pou2f3 driver to induce transgene expression, including the lineage tracer tdTomato or the oncogene . mTC lineage trace models of pancreatic neoplasia and carcinoma were used to follow mTC fate. We found that mTCs, in the carcinoma model, transdifferentiate into neural-like progenitor cells (NRPs), a cell type associated with poor survival in PDA patients. Using conditional knock-out and overexpression systems, we found that activity in mTCs is necessary and sufficient to induce this Tuft-to-Neuroendocrine-Transition (TNT).
PubMed: 38405804
DOI: 10.1101/2024.02.12.579982 -
International Journal of Surgery Case... Mar 2024Mucin hypersecretion promoted by intestinal metaplasia can lead to gallstone formation. The presence of large amounts of mucin induced by a change in biliary epithelium...
INTRODUCTION
Mucin hypersecretion promoted by intestinal metaplasia can lead to gallstone formation. The presence of large amounts of mucin induced by a change in biliary epithelium structure is called a mucocele, a usually benign condition studied among animals but rarely described in humans. This entity must be distinguished from hydrops, a condition secondary to an impacted gallstone in the cystic duct leading to an outlet obstruction and distension of the gallbladder.
PRESENTATION OF CASE
We report a case of a 51-year-old female with lithiasic cholecystitis showing areas of intestinal metaplasia associated with a mucocele. Laparoscopic cholecystectomy was performed with an uneventful postoperative course. Macroscopic findings revealed a dilated gallbladder filled with mucoid fluid. Signs of chronic and focally acute cholecystitis with areas of intestinal metaplasia were observed microscopically.
DISCUSSION
Lithiasic gallbladders can bear a gene that is found in goblet cells of intestinal metaplasia, leading to mucin hypersecretion. Metaplasia - a benign lesion often encountered on cholecystectomy specimens - can be the precursor of carcinoma. Mucin-producing gallbladder carcinoma is a very aggressive tumor that can appear as a mucocele. Consequently, preoperative computed tomography or magnetic resonance cholangiopancreatography should be performed in the presence of an unusual aspect on sonography.
CONCLUSION
Metaplastic changes in gallbladder epithelium associated with an overproduction of mucin and lithiasic cholecystitis reported in this case is a rarity. Malignancy is an alternative diagnosis of gallbladder mucocele that must be suspected whenever preoperative imaging of the gallbladder is atypical.
PubMed: 38402642
DOI: 10.1016/j.ijscr.2024.109405 -
Asian Journal of Surgery Jun 2024
Topics: Humans; Breast Neoplasms; Female; Middle Aged
PubMed: 38388266
DOI: 10.1016/j.asjsur.2024.02.022