Triple-negative Breast Cancer (TNBC) and Its Luminal Androgen Receptor (LAR) Subtype: A Clinicopathologic Review of Cases in a University Hospital in Northwestern Nigeria

Background

Breast cancer (BC) is a common malignancy; the most frequent in Nigeria. BC characteristically exhibits great biologic diversity. Amongst its variants, the triple-negative subtype is also characterized by heterogeneity (thus making it a study in diversity within diversity) and also by some unique clinicopathologic features including clinical aggressiveness, lack of response to current targeted therapies, and tendency to cluster amongst young premenopausal women especially in populations of women of African ancestry.

Aims

The objective of this study was to conduct a retrospective clinicopathologic survey of all breast carcinomas to profile the triple-negative breast cancers (TNBCs) amongst them and illustrate their immunohistochemical pattern of luminal androgen receptors (LARs) expression.

Patients and Methods

All the cases entered into the departmental records as breast carcinomas over the study period were extracted including patients' request cards, hematoxylin and eosin-stained slides, and paraffin-embedded tissue blocks of those diagnosed as triple-negative cancers. These were immunohistochemically stained using a monoclonal antibody for androgen receptor (AR). The whole data were analyzed and presented in tabular formats.

Results

A total of 660 breast carcinomas of which 89 (13.48%) cases were identified as TNBCs with a mean age of occurrence of 42.89 ± 11.88 years. Most TNBCs (95.5%) were carcinoma no special type and 61.8% had low or intermediate histologic grading. LAR expression was noted in 11.24% of the TNBCs.

Conclusion

Triple-negative cancer in this study shares some of the known characteristics but also portrays some divergence from the commonly described features.

Multiple symmetric lipomatosis of the male breast: An unusual mimic of gynecomastia

Multiple symmetric lipomatosis (MSL) is a very uncommon disease. Its etiopathogenesis is uncertain, although it has been linked to a variety of factors. Its main characteristic is the overgrowth of fat in form of an unencapsulated lesion. Most of the cases reported are in the head and neck region. We report a case that occurred in the breasts of a 62-year-old man. A clinical diagnosis of gynecomastia was initially made. Partial mastectomy was done and MSL was reported on histopathologic examination. Our literature search revealed no previous case of MSL in the breast reported from our environment.

Histopathologic spectrum of paediatric eye and ocular adnexal tumours: A 10-year review from a referral centre in Nigeria

Background

Tumours of the eye and adnexa demonstrate great histologic variety and constitute a serious threat to vision especially in children.

Aims

The study aims to review the epidemiologic and pathologic characteristics of tumours of the eye and ocular adnexa in the paediatric age group (0-14 years).

Methods

All the cases entered into the departmental records as tumours of the eye and ocular adnexa over a 10-year period in the age group 0-14 years were extracted. The patients' request cards with all relevant Haematoxylin & Eosin (H & E)-stained histology slides were retrieved. All the slides were reviewed and the cases were classified in accordance with the 4^th edition of the WHO Classification of Tumours of the Eye (2018). The collected data were subjected to descriptive statistical tabulation and analysis.

Results

A total of 104 tumours of the eye and ocular adnexae were diagnosed in the paediatric age group, accounting for 40.5% of all eye and ocular adnexal tumours diagnosed over the study period. The male to female ratio was 1.7:1 and malignant tumours greatly outnumbered benign tumours by a ratio of 5.5:1. Majority (76%) of the tumours occurred in the retina with retinoblastoma representing all the tumours diagnosed in this location. Rhabdomyosarcoma was the most common paediatric orbital tumour accounting for over half (53.8%) of all tumours in the orbit. Tumours of the conjunctiva and the eyelid were infrequent with benign soft tissue tumours (vascular, neural and lipomatous tumours) being the major tumours at these sites.

Conclusion

Retinoblastoma is the single most common tumour in this age group.

Recurrent depressive illness or craniopharyngioma: a diagnostic dilemma

BACKGROUND

Brain tumors have been associated with various psychiatric and neurological manifestations. However in some patients with brain tumors psychiatric symptom might be the only clinical presentation for various lengths of time. As such they would be treated as straight forward psychiatric disorders.

OBJECTIVE

To report a case of craniopharyngioma presenting as recurrent depressive illness in a 42 years old man.

METHODS

Clinical follow up of a patient presenting with recurrent depressive illness till death

RESULTS

recurrent severe depressive illness in the absence of focal neurological deficit that is unresponsive to anti-depressant might be due to intracranial neoplasm.

CONCLUSION

Brain tumors can sometime present as psychiatric disorders and be difficult to detect in the absences of focal neurological deficit and Neuro-imaging studies.

Reconstruction of the chest wall after excision of a giant malignant peripheral nerve sheath tumor

Primary chest wall tumors are uncommon and constitute 0.2-2% of all tumors. Metastatic tumors and tumors of local extension are more common. Malignant peripheral nerve sheath tumor (MPNST) of the chest wall is even rarer and its incidence on the chest wall not stated in the literature. The incidence in the general population is 0.0001% while the risk is approximately 4600 times higher in patients with type I neurofibromatosis and 3-13% of them will finally develop into MPNST, usually after latent periods of 10-20 years. Clinically, these tumors are aggressive, locally invasive, and highly metastatic. Excision of giant chest wall tumor leaves a defect that is reconstructed using musculocutaneous flaps with or without a mesh. We report the case of a 24-year-old man who presented at the surgical outpatient clinic with 7 months history of persistent left sided chest pain minimally relieved by analgesics, 5 months of cough and worsening dyspnoea, and 3 months history of anterior chest swelling on the left side of the manubrium. Following evaluation and investigations, the tumor was excised and the residual defect closed with methylmetacrylate sandwiched between two prolene meshes and overlaid with both pectoralis major muscles. The histology of the excised mass revealed MPNST He made an uneventful postoperative recovery, but died barely 3 months later from widespread pulmonary metastases. A review of the literature revealed that such tumors hardly ever reach such large-size as in our case.

Angiosarcoma of the small intestine

Primary gastrointestinal angiosarcomas are very rare and those of the small bowel even more rare. We report a case which is the first in the literature from this part of the world. It presented in a 25-year-old woman with multiple dissemination and rapid fatality. Diagnosis was based on histological morphology using Hematoxylin and Eosin (H and E) stains, plus reticulin special stain to outline the vascular nature.