Intracystic Papillary Carcinoma of Male Breast: A Rare Presentation - PDF document

See discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/230757266 Intracystic Papillary Carcinoma of Male Breast: A Rare Presentation of Cancer. Article · March 2012 CITATIONS READS 3 235 5 authors , including: Dhiraj Nikumbh SBH Government Medical College Dhule Maharashtra India 108 PUBLICATIONS 222 CITATIONS SEE PROFILE Some of the authors of this publication are also working on these related projects: HISTOPATHOLOGY View project Cytological evaluation View project All content following this page was uploaded by Dhiraj Nikumbh on 28 May 2014. The user has requested enhancement of the downloaded file.

Nikumbh Dhiraj B et.al . J ournal of medical research and practice ISSN NO- 2162-6391(Print) Available at www.jmrp.info 2162-6375(Online) O ri g i nal Arti cl e Intracystic Papillary Carcinoma of Male Breast: A Rare Presentation of Cancer * Dhiraj B.Nikumbh 1 , J yotsna V.Wader 1 , Hemant B.J anugade 2 , Avinash M.Mane 1 , Pallavi A.Shrigondekar 1 Author Affi l ati ons Abstr act 1 Department of Pathology, Breast carcinoma is an uncommon neoplastic condition among men, Krishna Institute of medical accounting for not more than 1% of all breast cancers and less than 0.1% of sciences, Karad, Maharashtra, male cancer deaths. Intracystic papillary carcinoma in men is an extremely India –415110. rare disease with only a few case reports published in literature so far. Since 2 Department of sur gery , papillary carcinoma has a favourable prognosis as compared to other Krishna Institute of medical histological subtypes, an accurate diagnosis is essential. sciences, Karad, Maharashtra, India –415110 We report a case of this rare histological type of breast cancer in 80 year old Cor r e spondi ng Author male with brief review of literature. Dr.Dhiraj B. Nikumbh, M.D. Assistant professor. Department of Pathology, KIMS, Karad, District - Ke y wor ds: - Breast neoplasms, intracystic papillary carcinoma, male breast . Satara, Maharashtra, India 415110. Contact no:+91- 9226894980. of the systemic examination was unremarkable. On Introduction: local examination, there was no gynaecomastia. A Breast carcinoma is an uncommon in males and 6x7 cm well circumscribed, firm, non tender, represents 0.6% of all breast carcinomas and less mobile mass was noted in left upper outer than 0.1% of all malignancies in men. Male breast quadrant (Figure 1) . Nipple appears to be cancer has an incidence of 1 per 1,00,000 per retracted. Bilateral axillary lymph nodes were not annum. 1 The predominant histological type is the palpable. Right Breast was normal. Fine needle infiltrating duct carcinoma (IDC) accounting for aspiration cytology of mass revealed ductal 70% of all cases. Even in female patients, invasive neoplastic cells s/ o ductal carcinoma of NOS type. papillary carcinoma is a rare morphological type. 2 All the biochemical, hematological and serological Intracystic papillary carcinoma (ICPC) accounts for investigations were within normal limit. The 5 to 7.5% of all male breast cancers 3 and only a patient underwent simple mastectomy with few cases reported published in the literature so axillary dissection. The specimen was sent for far. histopathological examination. Post operative was We report a case of intracystic papillary carcinoma uneventful. (ICPC) of breast in 80 year old male patient Figure 1: Gross appearance of left breast mass with retracted following mastectomy for Ca breast. nipple. Case report: An 80 year old man presented in surgical OPD of our hospital with painless round swelling in his left breast, since 2 months duration. He had noticed a rapid increase in size since 1 month. He was tobacco chewer since 10 years. There was no history of trauma, mumps, testicular injury, cirrhosis of liver, or any other contributing family history. On physical examination, the patient was averagely built and averagely nourished. The rest JMRP March 2012 Volume no 1 Issue 2 47

Nikumbh Dhiraj B et.al . J ournal of medical research and practice Gross examination: above findings, final diagnosis of Intracystic papillary carcinoma of an 80 year old male patient The mastectomy specimen measured 12x11x2.5 was given. Patient was on regular follow up. cms. The nipple was partially retracted and skin of the areola was wrinkled. On serial cut section Figure 4: Light microscopy showed fibrous cyst wall and showed a large cyst measuring 5x4 cm containing intracystic tumor in it (H &E stain x100) . dark black fluid with a tumor in it (Figure 2) . Tumor measures 4x4x3 cm and showed multiple papillary excrescences with gray white friable solid mass (Figure 3) . Skin was seen 0.3 cm away from tumor. Axillary dissection revealed 5 lymph nodes with larger measured 1.2 x 1 cm. Multiple sections were studied with haematoxylin and eosin. Figure 2: Gross appearance of mastectomy specimen with a tumor on serial cut section specimens. Figure 5: Tumor composed of multiple delicate, branching fronds lined by neoplastic epithelial cells (H &E stain x100). Figure 3: Cut surface of the specimen showed intracystic gray white tumor with multiple papillary excrescences. Figure 6: Light microscopy revealed neoplastic cells with fibrovascular core and pleomorphic,hyperchromatic nuclei with high nuclear cytoplasmic ratio (H &E Stain x400) . Light microscopy showed large cystic cavity filled with a papillary neoplasm. Fibrous cyst wall and a solid, complex papillary carcinoma projecting into the cyst lumen was noted (Figure 4) . Many areas showed portion of intracystic tumor with Discussion: fibrovascular stroma (Figure 5) . Tumor composed Breast carcinoma is an uncommon neoplastic of numerous delicate, branching papillary fronds condition among men, accounting for not more lined by neoplastic epithelial cells (Figure 6). than 1 percent of all breast cancers and less than These columnar epithelial cells exhibited mild 0.1 percent of male cancer deaths. 4 Several risk pleomorphic and hyperchromatic nuclei with a factors for the development of male breast high nuclear cytoplasmic ratio. Mitotic figures carcinoma have been identified, but elevated levels were variably present. Adjacent areas showed of estradiol and other estrogenic hormones are stromal desmoplasia. All peripheral surgical definitely implicated. 4 The proven risk factors are margins, overlying skin and all 5 lymph nodes in obesity, testicular disease, Klinefelters syndrome, axillary dissection were free from tumor. Based on JMRP March 2012 Volume no 1 Issue 2 48