Histopathological and immunohistochemical diagnosis of advanced medullary breast carcinoma: case report / Diagnóstico histopatológico e imuno-histoquímico de carcinoma medular avançado de mama: relato de caso

• Autor(a) principal: Lima, Ricardo Barbosa
• Data de Publicação: 2020
• Outros Autores: Kameo, Simone Yuriko, Vassilievitch, Andressa Cabral, Fonseca, Tiago Vasconcelos, Amorim, Bruno Ferreira, Costa, Jéssica dos Santos, Silva, Glebson Moura, Sawada, Namie Okino
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Brazilian Journal of Health Review
• Texto Completo: https://ojs.brazilianjournals.com.br/ojs/index.php/BJHR/article/view/7474
• topic: Delayed Diagnosis; Breast Neoplasms; Medullary Carcinoma; Medical Oncology; Prognosis

Medullary breast carcinoma (CMM) is a rare histological variant of breast cancer. It is a malignant and invasive tumor often observed in young women with large tumor lesions. There are still controversies about survival rates, about the histological pattern and prognosis of the CMM. The aim of this case report is to explain the histopathological diagnosis of a patient diagnosed with advanced medullary breast carcinoma, with emphasis on immunohistochemical findings. In a private oncology service, a 57-year-old woman came for treatment. At the initial clinical examination, it was observed that it presented a necrosis-like right breast tumor, firm on palpation and painful symptoms. An incisional lesion biopsy was performed and the cellular and molecular pattern traced. The report found the presence of advanced medullary breast carcinoma, necrotic malignant lesion in stage IV with bone and renal metastasis. The morphological pattern was composed of large epithelioid cells with pleomorphic and often multinucleated nuclei, with irregular chromatin distribution and atypical mitosis figures. The observed molecular pattern was focal expression of cytokeratin AE1 / AE3, smooth muscle actin, desmin, p63 and CD68. Additionally, the expressions of estrogen receptors, CD34, S-100 and CK8/18 were not observed. The tumor was unresectable and chemotherapy and radiotherapy was chosen to intervene in the disease progression, however, the patient died due to clinical complications resulting from these treatments associated with poor general health. CMM is a rare neoplasm and immunohistochemical studies may contribute to understand how morphological and molecular patterns may influence its clinical presentation.