Mucinous breast carcinoma with tall columnar cells

Mammary mucinous cystadenocarcinoma with long-term follow-up: molecular information and literature review

BACKGROUND

Mucinous cystadenocarcinoma (MCA) is a very rare form of breast cancer that was first described in 1998. Only 33 cases of primary MCA, including our present case, have been reported thus far. As a consequence, its molecular features, prognosis and treatment regimen are poorly known. Here, we describe a less common presentation of MCA, detail its molecular features, discuss the major differential diagnosis, and provide a brief review of the literature.

CASE PRESENTATION

A 59-year-old woman presented with a breast lump in which mammography showed a well-defined nodule. Core needle biopsy (CNB) revealed several lesions lined by tall columnar cells with stratification and abundant mucinous secretion; excision was recommended for final diagnosis. The resected specimens showed cavities of different sizes without surrounding myoepithelial cells. The cavities were rich in mucus, and the nuclei were located at the base of the cells, containing intracellular mucus. Immunohistochemical analysis revealed that it was triple-negative breast cancer (TNBC). Next-generation sequencing (NGS) revealed pathogenic mutations in the PIK3CA, KRAS, MAP2K4, RB1, KDR, PKHD1, TERT, and TP53 genes. A diagnosis of MCA was rendered. The patient has been followed up for 108 months to date and showed no signs of recurrence or metastasis.

CONCLUSION

Our study presents the gene profile of an MCA case with no recurrence or metastatic tendency after 108 months of follow-up, and a review of the literature helps us better understand the clinical, pathologic, and molecular features of this tumor.

Primary Breast Mucinous Cystadenocarcinoma and Review of Literature

Mucinous cystadenocarcinoma of the breast is a rare primary breast carcinoma having distinct clinical behavior and a favorable prognosis. It has a characteristic morphology that must be differentiated from metastatic ovarian and pancreatic mucinous adenocarcinoma. The etio-pathogenesis, genetic profile, and treatment of this tumor are controversial. Here, we report a case of primary mucinous cystadenocarcinoma of the breast in a 61-year-old female. The case is of interest since it is uncommon and has peculiar clinical and morphological features.

Primary synchronous colloid adenocarcinoma and squamous cell carcinoma in the same lung: A rare case report

RATIONALE

Double primary lung cancer (DPLC) is a relatively rare type of lung cancers. According to whether the diagnosis interval between lesions is more than 6 months, it can be divided into synchronous DPLC (sDPLC) and metachronous DPLC (mDPLC). Here, we describe a case of sDPLC in which one of the components is a rare colloid adenocarcinoma (CA).

PATIENT CONCERNS

A 69-year-old male was admitted to the hospital due to chest distress and shortness of breath for 1 year, getting worse in the last 15 days.

DIAGNOSIS

Both HE staining and IHC supported the diagnosis of CA in the right lower lobe and moderately differentiated squamous cell carcinoma in the right upper lobe.

INTERVENTIONS

The patient was treated with 3 cycles of adjuvant chemotherapy with pemetrexed and lobaplatin after the right upper lobectomy, wedge resection of the right lower lobe and lymph node dissection under video-assisted thoracoscope.

OUTCOMES

Our plan was to follow him up with general physical examination, chest-abdomen CT and serum tumor markers every 6 months for 2 years. The patient was still alive until the last follow-up in November 2020.

LESSONS

CA of the lung is a rare primary lung adenocarcinoma. The diagnosis should be based on the patient's clinical characteristics, imaging examination and pathological characteristics, and also need to be differentiated from other mucinous adenocarcinomas. Interestingly, our patient developed not only a CA in the right lower lobe, but also a moderately differentiated squamous cell carcinoma in the right upper lobe.

Mammary synchronous mucinous cystadenocarcinoma and columnar cell mucinous carcinoma: a case report

Mucin-producing carcinomas are unusual primary malignancies of breast, and constitute about 1-4 percent of total breast cancer. The mammary mucin producing carcinomas are divided into 4 histologic subtypes according to WHO classification, including mucinous carcinoma, mucinous cystadenocarcinoma (MCA), columnar cell mucinous carcinoma (CCMC), and signet ring cell carcinoma. However, the synchronous primary MCA and CCMC of breast is a very rare case presentation. The case reported a 56-year-old female, who presented with right mammary lumps and nipple discharge about 1 year. Imaging examinations revealed multiple cystic and solid nodules in upper outer quadrant of right breast, associated with ectatic ducts. Serum levels of tumor markers were normal. Right mammary lumpectomy revealed mucinous carcinoma, modified radical mastectomy, and lymph node dissection were carried out. For neoplastic cells, ER and PR were positive, HER2 (1+) was negative, Ki67 was low expression (3-5%). There was no metastatic carcinoma in lymph nodes (0/8). Modified radical mastectomy and lymph node dissections were carried out. Tamoxifen was chosen for adjuvant therapy. After a 3 month follow up, the patient survived without recurrences and distant metastasis. We report the first synchronous primary MCA and CCMC of breast with molecular subtype of Luminal A.

Giant Mucinous Carcinoma of the Breast

We report a case of giant mucinous carcinoma of the breast in a 55-year-old female who presented with left breast lump for two years. The patient did not seek any medical attention for two years. On exam, the lump measured 12 x 14 cm. Core needle biopsy showed invasive mucinous adenocarcinoma without ductal component. The patient underwent neo-adjuvant chemotherapy without any response. She underwent left modified radical mastectomy. All lymph nodes were negative. This was followed by adjuvant chemotherapy. Mucinous carcinoma is a rare type of breast cancer that carries a good prognosis compared to other types of breast cancers. In this report, we presented a giant mucinous carcinoma measuring 14 cm.