A Case of Primary Squamous Cell Carcinoma of the Breast With Mucin Formation and Positive Estrogen Receptor Assay

Nakasone, Tomonori; Kimino, Koji; Nakazaki, Takayuki; Yamashita, Hideki; Taketomi, Katsuro; Tobinaga, Koji; Kishikawa, Masao

doi:10.3919/ringe1963.58.102

Cited by 1 publication

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“…This is because the tumors have a rapid rate of evolution, and therefore the frequency of lymph node metastases is relatively higher than that of normal breast cancer, [ 6 ] although there is also a report showing that the frequency is low. [ 10 ] In the present cases, the tumor from Case 1 was 27 mm in diameter and that from Case 2 was 32 mm in diameter; although both tumors were classified as T2, they cannot be called extremely large tumors, and lymph node metastases were not observed in either case. Moreover, both cases tested negative for ERs and PgRs.…”

Section: Discussionmentioning

confidence: 47%

Case report

Yoneto¹,

Hasumi²,

Yoshimoto

et al. 2018

Medicine

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Rationale:Since primary pure squamous cell carcinoma of the breast is a rare disease, few reports describe the characteristic findings on performing preoperative imaging that can be used to distinguish it from normal breast cancer. The rapid evolution and lack of an established method of treatment has resulted in several reports of advanced cases of primary pure squamous cell carcinoma of the breast.Patient concerns:Case 1 was a 44-year-old woman with an elastic, hard tumor in the left C region. Ultrasonographic analysis revealed a maximal 11-mm hypoechoic area. Histologically, the tumor was a well-differentiated squamous cell carcinoma with prominent keratinization, and there was prominent inflammatory cell infiltration, necrosis, and fibrosis. Case 2 was a 58-year-old woman with an elastic, hard tumor in the left C/D region. Ultrasonographic analysis revealed a maximal 31-mm hypoechoic area with partially calcified areas and a hyperechoic margin. Histologically, the tumor was a squamous cell carcinoma with prominent keratinization exhibiting an infiltrative growth pattern. The tumor had no connection to the epidermis and partially transitioned into the atypical ductal epithelium in the area surrounding the focus.Diagnoses:The patient in Case 1 was preoperatively diagnosed with T1cN0M0 Stage I cancer of the left breast, but both patients were finally diagnosed with T2N0M0 Stage IIA cancer.Interventions:Case 1: left partial mastectomy and axillary lymph node dissection were performed. The patient was administered 4 courses of FEC100 and 4 courses of DTX as postoperative adjuvant therapy. Case 2: left modified radical mastectomy and axillary lymph node dissection were performed without any postoperative adjuvant therapy.Outcomes:Case 1: no sign of relapse was observed, but the patient moved away from the area to another hospital in March 2014 and eventually died due to relapse in January 2016. Case 2: four years after surgery, no relapse has been observed.Lessons:We should always keep the presence of primary pure squamous cell carcinoma among breast cancers in mind although the crisis rate is very low. Due to its high malignancy, needle biopsy and aspiration biopsy cytology should be performed to make a definitive diagnosis.

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Section: Discussionmentioning

confidence: 47%