11/218. Secretory carcinoma of the breast in a nine year old boy. carcinoma of the breast is very rare in childhood and is exceedingly rare in boys. Secretory carcinoma, a distinctive and rare variant of breast carcinoma is for some unknown reason the commonest type seen in children. To our knowledge there have been only four previous reports in boys under ten years old. We report the first case in australia of this unusual tumor in a nine year old boy. The child presented with a subareolar nodule 12 mm in its greatest dimension. High resolution sonography showed a well defined hypoechoic nodule. histology revealed classical features of secretory carcinoma with circumscribed, pushing margins, except for one site of invasion. The tumor displayed the typical cribriform and microcystic pattern with PAS positive, diastase resistant secretions, and lack of pleomorphism and mitotic activity. Tumor cells showed positive staining with S100 and polyclonal CEA and negative staining for estrogen and progesterone receptors. Although, because of its rarity, the natural history of this tumor is not well documented and optimal management is uncertain, prognosis happens to be excellent as these tumors behave in an indolent manner, both in children and in adults. ( info) |
12/218. Extra-abdominal desmoid mimicking malignant male breast tumor. A rare case of extra-abdominal desmoid tumor is reported. A palpable mass was detected in the right breast of a 47-year-old man. mammography showed a stellate mass without calcification, and breast ultrasound examination revealed a solid, inhomogeneous, non-calcified lesion. The result of cytological examination of the fine-needle aspiration biopsy specimen was equivocal. histology of the surgical specimen showed extra-abdominal desmoid tumor. Extra-abdominal presentation of this semimalignant tumor is rare and may mimic malignant breast tumor. Differential diagnosis is difficult and usually based on the result of the histological examination. ( info) |
13/218. Idiopathic thrombocytopenic purpura associated with breast cancer: a case report and review of the current literature. The association of solid tumors with idiopathic thrombocytopenic purpura (ITP) is rare. Before this study, there have been three case reports indicating an association between breast cancer and ITP. We present a 69-year-old man with metastatic breast cancer and progressive thrombocytopenia without any evidence of a leukoerythroblastic picture or etiologies for the thrombocytopenia. serum platelet antibodies were identified. A bone marrow biopsy showed small foci of metastatic breast cancer, thrombocytopenia, and normal number of megakaryocytes. A subsequent trial of steroids resulted in a marked improvement of the patient's thrombocytopenia. This is the fourth case report indicating an association of breast cancer and ITP. ( info) |
14/218. Immunoreactivity of prostate-specific antigen in male breast carcinomas: two examples of a diagnostic pitfall in discriminating a primary breast cancer from metastatic prostate carcinoma. Prostatic-specific antigen (PSA) is regarded as a specific marker secreted by normal and neoplastic acinar epithelial cells of the prostate gland; its detection by immunocytochemistry has been accepted as an indication of metastatic prostate cancer. This is ascribed to the commonly held belief that PSA is not found in extraprostatic tissues. However, this concept has recently been challenged, based on the observations that certain nonprostatic tissues and their neoplasms can also secrete PSA. Such a questionable belief could result in a diagnostic pitfall when using immunostaining for PSA on fine-needle aspiration (FNAC) cytology samples to differentiate metastatic prostate cancer from a primary carcinoma of an extraprostatic organ. In this communication, two cases of primary carcinomas of the male breast are reported in which PSA immunopositivity on FNAC led to the suggestion of a diagnosis of metastatic carcinoma of the prostate. Diagn. Cytopathol. 1999;21:167-169. ( info) |
15/218. Choroidal metastasis in men with metastatic breast cancer. PURPOSE: To report two cases of choroidal metastasis in metastatic breast cancer in men. METHOD: case reports of a 50-year-old man with an 8-year history of breast cancer who was initially examined with a solitary amelanotic choroidal tumor and a 62-year-old man with an 8-month history of breast cancer who was initially examined with numerous unilateral amelanotic choroidal tumors. RESULTS: Ophthalmoscopic and echographic characteristics of the choroidal tumors were typical for breast cancer metastasis. Systemic screening disclosed advanced metastatic disease in both patients. Choroidal metastasis could be effectively treated by external beam irradiation. CONCLUSIONS: Although breast cancer is a rare condition in men, it should be considered as a possible primary cancer in cases of choroidal metastasis. ( info) |
16/218. Myofibroblastoma of breast: evidence favoring smooth-muscle rather than myofibroblastic differentiation. A histopathological study of two cases of the tumor known in the literature as myofibroblastoma of the breast is presented. The tumors occurred in Caucasian males aged 57 and 62 years. Histologically, these were moderately cellular, lobulated spindle-cell lesions, each with a reasonably well-delineated edge with surrounding fatty connective tissue. No breast ducts or lobules were present. Tumor cell nuclei were bland, with small nucleoli and some nuclear grooving. Nuclear atypia and mitoses were absent. Immunostaining revealed positivity for a-smooth-muscle actin, desmin, and CD34. Tumor cells contained rough endoplasmic reticulum, bundles of myofilaments with focal densities, intermediate filaments, attachment plaques alternating with plasmalemmal caveolae, and focal lamina. Ultrastructural findings pointed to true smooth-muscle differentiation, and the cell-surface in particular lacked surface features of myofibroblasts (fibronectin fibrils [microtendons] and fibronexus junctions). These and published data suggest that at least some of the lesions referred to in the literature as myofibroblastoma may not be myofibroblastic and may be better designated as myogenic stromal tumors or as variants of leiomyoma. ( info) |
17/218. Fine needle aspiration cytology (FNAC) of mammary granular cell tumour: a report of three cases. This report describes the FNAC findings in three cases of granular cell tumour of the breast. The patients comprised two females aged 59 and 62 years and one male aged 28 years. All patients presented with a breast lump which was clinically and radiologically suspicious of malignancy. FNAs yielded moderately cellular specimens which on cytologic examipation consisted of groups of cells and single cells with small regular nuclei and abundant granular cytoplasm. Bare nuclei were also present but these did not have the characteristic bipolar appearance of myoepithelial cells. In two cases there was a granularity to the background. The aspirates were reported as equivocal or atypical, probably benign, and surgical biopsy was performed. Histological examination showed typical benign granular cell tumours with strong positive staining for S-100 protein. Pathologists should be aware that granular cell tumour may occur in or around the breast and should consider this diagnosis in aspirates containing a population of cells with regular nuclei and abundant granular cytoplasm. The main cytologic differential diagnoses are likely to be apocrine cells and histiocytes. The suspicion of a granular cell tumour should be heightened when these features are present in an aspirate from a clinically and radiologically suspicious mass. These cases highlight the role of the triple approach encompassing clinical, radiological and cytological features in the assessment of a breast lesion. ( info) |
18/218. Haemangiopericytoma of the adult male breast. Haemangiopericytoma is an uncommon, usually benign, soft tissue tumour which has been rarely reported to occur in the female breast. Haemangiopericytoma of the adult male breast has been reported only once before. We report another such case. ( info) |
19/218. Juvenile papillomatosis of the breast in male infants: two case reports. Juvenile papillomatosis of the breast ("Swiss cheese disease") is a benign localized proliferative condition of the breast which occurs almost exclusively in young adult women. patients with this lesion often have a family history of breast carcinoma, and rarely carcinoma may coexist with the lesion at the time of diagnosis. We present two cases of male infants with juvenile papillomatosis of the breast. The pathology and clinical management of this novel lesion is discussed. ( info) |
20/218. plasmacytoma of the breast. A report of two cases diagnosed by aspiration biopsy. BACKGROUND: Extramedullary plasmacytoma of the breast is an uncommon neoplasm, occurring either as a solitary tumor or as evidence of disseminated multiple myeloma. CASE: Two cases of plasmacytoma of the breast were diagnosed by fine needle aspiration cytology. Aspiration smears showed a dispersed population of plasmacytoid cells with eccentric nuclei, abundant cytoplasm and the characteristic paranuclear hof. CONCLUSION: The clinical, cytologic and immunophenotypic features of plasmacytoma are characteristic, and the importance of distinguishing these neoplasms from primary mammary tumors is important to avoid unnecessary surgery. ( info) |