31th European Congress of Pathology, Nice, Fransa, 7 - 11 Eylül 2019, cilt.31, ss.16
No special type invasive breast carcinoma transformed to metaplastic
carcinoma after neoadjuvant chemotherapy
, Z.C. Olgun1
, O. Alimoglu2
1 Istanbul Medeniyet University, Department of Pathology, Turkey,
2 Istanbul Medeniyet University, Department of General Surgery, Turkey
Background & Objectives: Metaplastic breast carcinoma is a rare and
aggressive type of breast carcinoma. Here, we report a case of metaplastic
breast carcinoma which transformed from Invasive Breast Carcinoma, No
Special Type (NST) following neoadjuvant chemotherapy (NAC).
Methods: 46 year-old woman presented with a palpable mass which was
diagnosed with tru cut biopsy as invasive breast carcinoma, NST. The
patient received 4 cycles of NAC with anthracyclin and taxane
Results: The patient underwent a segmental mastectomy after NAC.
Microscopically the tumour was arranged in a diffuse pattern.
Tumour cells had large vesicular, irregular nuclei with prominent
nucleoli and abundant cyoplasm. Necrosis was detected in large
areas. The neoplastic cells of the excised tumour were estrogen
receptor (ER), progesterone receptor (PR), and HER-2 negative
whereas on previous biopsy tumour cells were diffusely positive
for ER and PR and negative for HER-2. After NAC tumour showed
diffuse positivity for EGFR and vimentin, scattered cells stained
with P63 and HMWCK. EMA was patchy and weakly positive at
neoplastic cells. Tumour was negative for PANCK, CAM 5.2,
Cytokeratin 5/6, Cytokeratin 14, and CD34. So the tumour was
consistent with metaplastic carcinoma.
Conclusion: Immunhistochemical changes after NAC is not an uncommon finding but morphologic transformation is very rare entitiy. This is
the third case of transformation to metaplastic carcinoma after NAC as far
as we know from English literature.