Journal de pathologie clinique et expérimentale

Abstrait

An Unusual Case of High Grade Triple Negative Intracystic Solid Papillary Carcinoma of Breast with Invasive Component

Junainah E, Baslaim M, Huwait HF, Shigairi S, Nemenqani D, Saber A, Junainah M, Alzahrani S, Junainah J and Junainah F

Background: Intracystic (encysted) papillary carcinoma (IPC) is a rare distinct entity of breast cancer, usually asymptomatic, sometimes presented as breast mass or nipple discharge. It shows benign appearance on imaging. Ultrasonography shows pure cyst or mixed image, sometime solid mass. Pathologically can be divided into pure form, or associated with ductal carcinoma in situ (DCIS) or invasive carcinoma. It is considered as noninvasive or minimally invasive, because there is no infiltrating growth pattern and metastases are rare. Traditionally considered to lack a myoepithelial layer, it has favorable prognosis even with invasion. Stromal invasion found in 92%. In case of high grade variant which diagnosed by high nuclear grade and high mitotic activity, usually triple negative and p53+ as we have in our case?

Case presentation: We report a case of breast cancer that occurred in 42-year-old woman presented with a painless lump in the left breast, FNA yielded hemorrhagic fluid. Patient underwent wide local Excision. The final histopathological finding shows encapsulated/intra cystic carcinoma, papillary variant with high grade features, as defined by nuclear pleomorphic and increased mitotic activity. This tumor is also hormone receptor and HER-2- negative, and is associated with stromal invasion by high grade NOS.

Conclusion: High grade encapsulated papillary carcinoma is extremely rare variant, usually associated with invasive component; morphologically it is more aggressive. It behaves like its invasive counterpart.