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Background Apocrine carcinoma is a rare tumor that constitutes < 4% of all breast malignancies, characterized by the proliferation of large atypical cells with strictly defined borders, abundant eosinophilic cytoplasm, large nuclei, and prominent nucleoli in more than 90% of tumor cells. Triple-negative apocrine carcinoma is a rare molecular subtype that constitutes less than 1% of triple-negative breast cancers and is characterized by negative expression of estrogen receptor, progesterone receptor, and human epidermal growth factor receptor, with positive expression of androgen receptor. Case presentation We report a case of a 45-year-old Syrian female who presented to our hospital due to a painless palpable mass in her left breast. Following physical and radiological examinations, an excisional biopsy was performed. Microscopic examination of the specimen followed by immunohistochemical staining revealed the diagnosis of a triple-negative apocrine carcinoma. Conclusion Triple-negative apocrine carcinoma is an extremely rare neoplasm that must be considered in the differential diagnoses of breast lesions through detailed clinical, histological, and immunohistochemical correlations. In our manuscript, we aimed to present the first case report of a Syrian female who was diagnosed with a triple-negative apocrine carcinoma, aiming to highlight the importance of detailed clinical, histological and immunohistochemical correlations with a detailed review of diagnostic criteria, molecular characteristics, and treatment recommendations.

Metaplastic breast carcinoma (MBC) is a diverse group of invasive breast carcinoma, in which the neoplastic epithelium differentiates toward squamous cells or mesenchymal looking elements, including but not restricted to spindle, osseous and chondroid cells. MBC was formally considered a distinct pathological pattern by WHO classification of breast tumors in 2000. We report the case of a 49-year-old Syrian female who presented to our hospital due to a painful huge mass in her right breast. Radiographic and clinical findings were highly indicative of breast carcinoma. Therefore, a core needle biopsy was performed, and surprisingly, microscopic examination suggested the diagnosis of soft tissue sarcoma, whereas immune stains confirmed the diagnosis of metaplastic carcinoma. We aim to introduce a challenging case that clarifies the rarity of this tumor, and the methods we used in diagnosing, examining and treating this malignancy.