Fine Needle Aspiration Cytology of Metastatic Choriocarcinoma Presenting as a Breast Lump

Fine Needle Aspiration Cytology of Mammary Carcinoma with Choriocarcinomatous Features

“…The cytopathologic features of BCCF are hemorrhagic necrosis and MGCs, which resemble syncytiotrophoblastic cells, and a sheet-like arrangement of round to oval-shaped epithelial cells with prominent nucleoli, which were thought to correspond to intermediate trophoblasts. 3,5 Choi et al 21 Histologically, such tumors show pleomorphic areas of large, oval-shaped tumor cells with a high nuclear to cytoplasmic ratio and increased nuclear chromatin. The cytoplasm of the tumor cells is pale to eosinophilic.…”

Cytologic Features of Hydatidiform Mole

“…If the smear is composed predominantly of highly atypicalappearing trophoblastic cells as in our case, differentiation from other malignant tumors may be required, 6 and the specific cytodiagnosis of hydatidiform mole in a cervical cytologic specimen may be extremely difficult. Differential diagnosis includes choriocarcinoma or other malignant tumors, most commonly squamous cell carcinoma.…”

“…7 Both choriocarcinoma and hydatidiform mole have trophoblastic cells, especially syncytiotrophoblastic elements. But choriocarcinoma is basically a large cell, undifferentiated malignant neoplasm with hemorrhagic and necrotic background, 6 which a hydatidiform mole is not.…”

“…These cells can be highly atypical and are apt to be mistaken as dysplastic or malignant cells. Therefore an intensive search for the syncytiotrophoblastic elements and diagnostic adjunct by means of immunohistochemical studies 6 or clinical assessment of serum levels of specific tumor markers, including quantitative β-hCG, 6 may allow its identification and a specific diagnosis such as hydatidiform mole on cervical smears. Also, correlation of the cytopathologic features or results of other diagnostic adjuncts with the patient's clinical history is the key to the accurate diagnosis and forgoing of unnecessary procedures.…”

Atypical Case of Choriocarcinoma with Breast Metastasis

“…Metastasis to the breast is very rare [2]. Since choriocarcinoma is a rapidly invasive, widely metastasizing malignancy with good response to chemotherapy, it is important to obtain early diagnosis for better outcome [3]. Because of the rarity of the disease and the importance of early detection and management, we report a case of choriocarcinoma presenting with a breast lump.…”