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Bilateral synchronous low-grade adenosquamous carcinoma of the breast: A Case report with review of the current literature

INTRODUCTION: Low-grade adenosquamous carcinoma (LGASC) is a rare, unique variant of metaplastic breast carcinoma, characterized by clinical indolence and low-grade cytomorphology. Being clinically asymptomatic with indefinite imaging characteristics, diagnosis is solely dependent on histopathology....

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Autores principales: Senger, J.L., Meiers, P., Kanthan, R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4573407/
https://www.ncbi.nlm.nih.gov/pubmed/26218176
http://dx.doi.org/10.1016/j.ijscr.2015.06.040
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author Senger, J.L.
Meiers, P.
Kanthan, R.
author_facet Senger, J.L.
Meiers, P.
Kanthan, R.
author_sort Senger, J.L.
collection PubMed
description INTRODUCTION: Low-grade adenosquamous carcinoma (LGASC) is a rare, unique variant of metaplastic breast carcinoma, characterized by clinical indolence and low-grade cytomorphology. Being clinically asymptomatic with indefinite imaging characteristics, diagnosis is solely dependent on histopathology. PRESENTATION OF CASE: A 68-year-old woman presented to the Breast Health Center with mammogram-detected left-sided retroareolar calcifications. She had a three-year history of non-progressive bilateral nipple inversion, and was otherwise asymptomatic. Left breast biopsy revealed atypical metaplastic squamous epithelial cells. Subsequently a wire-guided lumpectomy diagnosed a syringomatous adenoma of the nipple. A surveillance MRI identified a contralateral breast lesion, which on core biopsy showed an atypical adenosquamous lesion. Bilateral central mastectomies with bilateral sentinel node biopsies were undertaken. Histopathological review of both breast specimens confirmed the unique features of adenosquamous carcinoma identified by an infiltrative pattern of small rounded compressed angulated glands with squamous differentiation and low-grade cytomorphology. The tumors were triple negative [ER, PR, HER2]. The sentinel lymph nodes were negative. CONCLUSION: Bilateral synchronous LGASC of the breasts is exceedingly uncommon and remains a diagnostic and therapeutic challenge. Despite being triple negative, due to its indolent behavior, recognition of this unusual primary breast malignancy is important as it has a more favorable prognosis. Yet, due to its rarity, there are no guidelines for best practice management regarding the role of adjuvant therapy.
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spelling pubmed-45734072015-10-19 Bilateral synchronous low-grade adenosquamous carcinoma of the breast: A Case report with review of the current literature Senger, J.L. Meiers, P. Kanthan, R. Int J Surg Case Rep Case Report INTRODUCTION: Low-grade adenosquamous carcinoma (LGASC) is a rare, unique variant of metaplastic breast carcinoma, characterized by clinical indolence and low-grade cytomorphology. Being clinically asymptomatic with indefinite imaging characteristics, diagnosis is solely dependent on histopathology. PRESENTATION OF CASE: A 68-year-old woman presented to the Breast Health Center with mammogram-detected left-sided retroareolar calcifications. She had a three-year history of non-progressive bilateral nipple inversion, and was otherwise asymptomatic. Left breast biopsy revealed atypical metaplastic squamous epithelial cells. Subsequently a wire-guided lumpectomy diagnosed a syringomatous adenoma of the nipple. A surveillance MRI identified a contralateral breast lesion, which on core biopsy showed an atypical adenosquamous lesion. Bilateral central mastectomies with bilateral sentinel node biopsies were undertaken. Histopathological review of both breast specimens confirmed the unique features of adenosquamous carcinoma identified by an infiltrative pattern of small rounded compressed angulated glands with squamous differentiation and low-grade cytomorphology. The tumors were triple negative [ER, PR, HER2]. The sentinel lymph nodes were negative. CONCLUSION: Bilateral synchronous LGASC of the breasts is exceedingly uncommon and remains a diagnostic and therapeutic challenge. Despite being triple negative, due to its indolent behavior, recognition of this unusual primary breast malignancy is important as it has a more favorable prognosis. Yet, due to its rarity, there are no guidelines for best practice management regarding the role of adjuvant therapy. Elsevier 2015-07-13 /pmc/articles/PMC4573407/ /pubmed/26218176 http://dx.doi.org/10.1016/j.ijscr.2015.06.040 Text en © 2015 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Senger, J.L.
Meiers, P.
Kanthan, R.
Bilateral synchronous low-grade adenosquamous carcinoma of the breast: A Case report with review of the current literature
title Bilateral synchronous low-grade adenosquamous carcinoma of the breast: A Case report with review of the current literature
title_full Bilateral synchronous low-grade adenosquamous carcinoma of the breast: A Case report with review of the current literature
title_fullStr Bilateral synchronous low-grade adenosquamous carcinoma of the breast: A Case report with review of the current literature
title_full_unstemmed Bilateral synchronous low-grade adenosquamous carcinoma of the breast: A Case report with review of the current literature
title_short Bilateral synchronous low-grade adenosquamous carcinoma of the breast: A Case report with review of the current literature
title_sort bilateral synchronous low-grade adenosquamous carcinoma of the breast: a case report with review of the current literature
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4573407/
https://www.ncbi.nlm.nih.gov/pubmed/26218176
http://dx.doi.org/10.1016/j.ijscr.2015.06.040
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