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Metaplastic Carcinoma with Chondroid Differentiation Arising in Microglandular Adenosis

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초록

Microglandular adenosis (MGA) of the breast is a rare, benign proliferative lesion but with a significant rate of associated carcinoma. Herein, we report an unusual case of metaplastic carcinoma with chondroid differentiation associated with typical MGA. Histologically, MGA showed a direct transition to metaplastic carcinoma without an intervening atypical MGA or ductal carcinoma in situ component. The immunohistochemical profile of the metaplastic carcinoma was mostly similar to that of MGA. In both areas, all the epithelial cells were positive for S-100 protein, but negative for estrogen receptor, progesterone receptor, HER2/neu, and epidermal growth factor receptor. An increase in the Ki-67 and p53 labelling index was observed from MGA to invasive carcinoma. To the best of our knowledge, this is the first case of metaplastic carcinoma with chondroid differentiation arising in MGA in Korea. This case supports the hypothesis that a subset of MGA may be a non-obligate morphologic precursor of breast carcinoma, especially the triple-negative subtype.

Abstract

Microglandular adenosis (MGA) of the breast is a rare, benign proliferative lesion but with a significant rate of associated carcinoma. Herein, we report an unusual case of metaplastic carcinoma with chondroid differentiation associated with typical MGA. Histologically, MGA showed a direct transition to metaplastic carcinoma without an intervening atypical MGA or ductal carcinoma in situ component. The immunohistochemical profile of the metaplastic carcinoma was mostly similar to that of MGA. In both areas, all the epithelial cells were positive for S-100 protein, but negative for estrogen receptor, progesterone receptor, HER2/neu, and epidermal growth factor receptor. An increase in the Ki-67 and p53 labelling index was observed from MGA to invasive carcinoma. To the best of our knowledge, this is the first case of metaplastic carcinoma with chondroid differentiation arising in MGA in Korea. This case supports the hypothesis that a subset of MGA may be a non-obligate morphologic precursor of breast carcinoma, especially the triple-negative subtype.

참고문헌 (11)

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  7. Zhong F, "Carcinoma arising in microglandular adenosis of the breast: triple negative phenotype with variable morphology", Int J Clin Exp Pathol, 7, pp.6149~6156 (2014)
  8. Liu LY, "A case of matrix-producing carcinoma of the breast with micoglandular adenosis and review of literature", Int J Clin Exp Pathol, 8, pp.8568~8572 (2015)
  9. 최정은, "Invasive Breast Carcinoma Arising in Microglandular Adenosis: Two Case Reports", Journal of Breast Cancer, 16(4), pp.432~437 (2013), 한국유방암학회
  10. Shin SJ, "Molecular evidence for progression of microglandular adenosis (MGA) to invasive carcinoma", Am J Surg Pathol, 33, pp.496~504 (2009)
  11. Guerini-Rocco E, "Microglandular adenosis associated with triple-negative breast cancer is a neoplastic lesion of triple-negative phenotype harbouring TP53 somatic mutations", J Pathol, 238, pp.677~688 (2016)

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