11/519. Papillary carcinoma-in-situ of the breast presenting as a fungating lesion. We report a case of papillary breast carcinoma-in-situ which presented as a fungating lesion. To our knowledge this is the first such case to be reported in the English language literature. ( info) |
12/519. Mammary endocrine ductal carcinoma in situ: a case report. Endocrine differentiation represents a pathway of neoplastic development available to a range of breast cancers. This pattern occurs in tumors with different morphological appearances as ductal carcinoma in situ (DCIS), mucinous carcinoma, a variant of lobular carcinoma, and low-grade invasive ductal carcinoma. Endocrine ductal carcinoma in situ is an uncommon entity. It occurs in older women with a mean age of 70 years. Histologically it shows expansile intraductal growth forming solid sheets and festoons transversed by delicate fibrovascular septa. Conventional microscopy permits the diagnosis in most cases. Specialized techniques such as immunohistochemistry and electron microscopy can serve as the basis of diagnosis in the absence of the appropriate morphological features. We present a 68-year-old female with a 1.5-cm firm mobile nodule of the left breast. mammography and ultrasounds showed a 15 x 15-mm circumscribed solid lobulated nodule. The mass was excised and pathology was positive for endocrine DCIS. Although endocrine DCIS has a biologic marker profile similar to that of well-differentiated or noncomedo DCIS it may constitute a different histogenetic pathway of carcinogenesis in the breast. The tumor may exhibit the invasive characteristics of a neuroendocrine neoplasm. Larger studies and longer follow-up are needed for the determination of the clinical behavior. ( info) |
13/519. Pulsatile audible tinnitus and metastatic breast carcinoma of the temporal bone. Metastases into the temporal bone are uncommon and typically present with trivial otological symptoms. We report a rare case of pulsatile audible tinnitus caused by metastatic breast carcinoma of the temporal bone. ( info) |
| A case of advanced male breast cancer which masqueraded as recurrent abscess of the right breast is presented to highlight the role of contra-lateral rectus abdominis pedicled myocutaneous flap in providing adequate skin and soft tissue cover in male breast reconstruction. This was carried out for this patient following a modified radical mastectomy for stage III (T2b, N2, M0) intraductal carcinoma of the breast. The patient has remained well without clinical features of distant metastasis at a follow up period of two years despite periodic excision of locally recurrent cancer nodules from the affected breast. ( info) |
15/519. Lobular carcinoma in situ and infiltrating ductal carcinoma: frequent presence of DCIS as a precursor lesion. Infiltrating ductal carcinoma (IDC) occurs frequently in patients with lobular carcinoma in-situ (LCIS). LCIS is not thought to be the direct precursor of the invasive component. The authors analyzed 15 cases of coexisting LCIS and IDC and found ductal carcinoma in situ (DCIS) in 12. The DCIS and IDC were of similar grade and located in the same area. Selected cases stained with E-cadherin demonstrated a different immunophenotype for the lobular and ductal lesions. These results support the notion that DCIS is the direct precursor of IDC occurring in patients with LCIS. ( info) |
| We report a case of meningioma subsequently developed in a patient with primary breast carcinoma. A 53-year-old woman received a left modified radical mastectomy because of stage IIA breast carcinoma. Histologically, the tumor was a predominantly intraductal carcinoma with negative lymph node metastasis. Estrogen receptor (ER) was negative but progesterone receptor (PR) of the left tumor was positive by immunohistochemistry. Four years later, cranial bone and/or brain metastasis was suspected from a routine follow-up bone scintigram. The patient showed no symptoms or signs at that time. magnetic resonance imaging (MRI) and angiography revealed that the right parasagittal mass was suspicious of meningioma. A complete tumor removal was performed. On histological examination, this brain tumor was a transitional-type meningioma (meningotheliomatous and fibrous type) without malignant findings. ER was negative but PR was positive also in this tumor. She is currently well 6 years after the initial surgery. A review of the literature is presented with emphasis on the association between breast cancer and meningioma, which indicates a possible hormonal relationship. The knowledge of this association is important in the differential diagnosis of patients with breast cancer who develop central nervous manifestations. ( info) |
17/519. Male ductal carcinoma in situ presenting as bloody nipple discharge: a case report and literature review. Male breast carcinoma accounts for 1% of all diagnosed breast carcinoma. Pure ductal carcinoma in situ in men is extremely rare. Unfortunately, male breast cancer is often diagnosed at a late stage because of the minimal awareness of presenting symptoms by the patient and sometimes by the health care provider. Because of this late presentation, the overall prognosis is less favorable. This case is presented to emphasize the importance of recognizing bloody nipple discharge as a clinical sign of male ductal carcinoma in situ and an opportunity for early diagnosis. ( info) |
18/519. An elderly patient with DCIS of the breast effectively treated with toremifene alone. An elderly patient with breast cancer received toremifene monotherapy for one year, and about 60% tumor remission rate was obtained. Since viability of the residual tumor was suspected on ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI), lumpectomy was performed under local anesthesia. The histopathological diagnosis was ductal carcinoma in situ (DCIS). The patient did not undergo axillary lymph node dissection or systemic chemotherapy. The patient is alive without disease under postoperative radiotherapy and toremifene treatment. toremifene monotherapy and/or preoperative adjuvant therapy with toremifene alone may be useful methods for elderly patients with breast cancer considering the patients' quality of life. ( info) |
19/519. gynecomastia with marked cellular atypia associated with chemotherapy. gynecomastia is a common benign male breast disease, which may exhibit mild cellular atypia in cytology specimens. However, marked cytologic atypia can be seen in gynecomastia superimposed by chemotherapy. The case described in this report demonstrated severe cytologic atypia of gynecomastia mimicking carcinoma in a patient treated with chemotherapy for acute leukemia. A distinct cytologic feature helpful in avoiding the diagnostic error is described, namely, atypical cells admixed with bland ductal cells and appearing at a different plane. The importance of applying strict diagnostic criteria in breast cytology and clinical correlation is also emphasized. ( info) |
20/519. Invasive ductal carcinoma associated with tubular adenoma of the breast. We report an extremely rare case of the colocalization of a tubular adenoma and an invasive ductal carcinoma occurring in a 55-year-old woman. Following radiographical evaluation, fine-needle aspiration cytology of the left breast tumor was undertaken. Because cytological examination revealed malignancy, a partial mastectomy was performed. Histologically, the tumor (measuring 1.7 x 1.3 cm) comprised two distinct parts: tubular adenoma and invasive ductal carcinoma. The invasive ductal carcinoma showed a solid pattern, high nuclear and structural atypia and frequent mitotic figures, while the tubular adenoma consisted of a proliferation of small ducts lined by single layers of epithelial and myoepithelial cells with bland nuclei and inconspicuous nucleoli. The histological boundary was clearly defined between the tubular adenoma and the invasive ductal carcinoma, and between the tubular adenoma and the surrounding breast tissue. The current case might be a collision between separate tubular adenoma and invasive ductal carcinoma, but the malignant transformation of a tubular adenoma cannot be ruled out. Both the long-term observation of this case and analysis of more cases may enable us to determine the histological characteristics and clinical significance of invasive ductal carcinoma associated with tubular adenoma. ( info) |