Metaplastic breast cancer: clinical significance

Beatty, J. David; Atwood, Mary; Tickman, Ronald; Reiner, Maureen

doi:10.1016/j.amjsurg.2006.01.038

“…They usually present with a large, painful mass in the breast (12). Rarely, nipple discharge, nipple retraction and skin ulcerations may be observed (13). Depending on the lymphatic involvement of the disease, axillary lymphadenopathy may accompany.…”

Section: Discussionmentioning

confidence: 99%

Breast Carcinosarcomas

Yakan¹,

Sari²,

Erkan³

et al. 2014

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“…For example, in the breast and the pancreas, carcinomas with squamous differentiation have been shown to be aggressive neoplasia with a prognosis even worse than that of conventional adenocarcinomas of these respective sites. [33][34][35][36] Whether this is also valid for squamous cell carcinoma/adenosquamous carcinoma of gallbladder or not has yet to be proven.…”

mentioning

confidence: 99%

Squamous cell and adenosquamous carcinomas of the gallbladder: clinicopathological analysis of 34 cases identified in 606 carcinomas

Roa

¹

,

Tapia

²

,

Çakır

³

et al. 2011

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The information in the literature on squamous cell and adenosquamous carcinomas of the gallbladder is highly limited. In this study, 606 resected invasive gallbladder carcinoma cases were analyzed. Squamous differentiation was identified in 41 cases (7%). Those without any identifiable glandular-type invasive component were classified as pure squamous cell carcinomas (8 cases) and those with the squamous component constituting 25-99% of the tumors were classified as adenosquamous carcinomas (26 cases) and included into the analysis. The remaining 7 that had o25% squamous component were classified as adenocarcinoma with focal squamous change and excluded. The clinicopathological characteristics of adenosquamous carcinoma/squamous cell carcinomas were documented and contrasted with that of ordinary gallbladder adenocarcinomas. The average patient age was 65 years (range 26-81); female/male ratio, 3.8. In only 13%, there was a preoperative clinical suspicion of malignancy. Grossly, 58% presented as thickening and hardening of the wall and 6% were polypoid. In 12%, mucosa adjacent to the tumor revealed squamous metaplasia. All pure squamous cell carcinomas had prominent keratinization. Giant cells and tumor-infiltrating eosinophils were observed in 29 and 51% of the squamous cell carcinomas/adenosquamous carcinomas versus 10% (P ¼ 0.02) and 6% (P ¼ 0.001) in gallbladder adenocarcinomas, respectively. All but three cases had 'advanced' (pT2 and above) carcinomas. Follow-up was available in 31 patients: 25 died of disease (median ¼ 5 months, range 0-20), and 6 were alive (median ¼ 64 months, range 5-112.5). The survival of patients with squamous cell carcinomas/adenosquamous carcinomas was significantly worse than that of gallbladder adenocarcinomas (P ¼ 0.003), and this adverse prognosis persisted when compared with stage-matched advanced gallbladder adenocarcinoma cases (median ¼ 11.4 months, P ¼ 0.01). In conclusion, squamous differentiation was noted in 7% of gallbladder carcinomas. The incidence of adenosquamous carcinoma (defined as 25-99% of the tumor being squamous) was 4%, and that of pure squamous cell carcinoma (without any documented invasive glandular component) was 1%. Pure squamous cell carcinomas often showed prominent keratinization. The overall prognosis of adenosquamous carcinoma/squamous cell carcinoma appears to be even worse than that of ordinary adenocarcinomas. Most patients died within a few months; however, those few who were alive beyond 2 years in this cohort experienced long-term survival.

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“…This, however, may not be surprising as squamous differentiation in carcinomas of glandular organs often occur as a result of 'metaplastic' change, which often occurs as a part of 'dedifferentiation'. 33,35,36,48 For example, in the breast, squamous differentiation is often a part of sarcomatoid carcinomas and highgrade transformation, and regarded under the category of 'metaplastic' carcinomas. 36,48,49 On the other hand, although many gallbladder adenosquamous carcinomas/squamous cell carcinomas showed highgrade histologic features, it may also be important to note that focal aberrant differentiation toward other cell lineages such as sebaceous differentiation and goblet cells (Figures 7 and 8) were also occasionally encountered in these tumors.…”

Section: Discussionmentioning

confidence: 99%

Gallbladder Squamous Cell Carcinoma with Chronic Right Upper Quadrant Discomfort

Park¹,

Lee²,

Hong³

et al. 2018

Clin Ultrasound

0

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The information in the literature on squamous cell and adenosquamous carcinomas of the gallbladder is highly limited. In this study, 606 resected invasive gallbladder carcinoma cases were analyzed. Squamous differentiation was identified in 41 cases (7%). Those without any identifiable glandular-type invasive component were classified as pure squamous cell carcinomas (8 cases) and those with the squamous component constituting 25-99% of the tumors were classified as adenosquamous carcinomas (26 cases) and included into the analysis. The remaining 7 that had o25% squamous component were classified as adenocarcinoma with focal squamous change and excluded. The clinicopathological characteristics of adenosquamous carcinoma/squamous cell carcinomas were documented and contrasted with that of ordinary gallbladder adenocarcinomas. The average patient age was 65 years (range 26-81); female/male ratio, 3.8. In only 13%, there was a preoperative clinical suspicion of malignancy. Grossly, 58% presented as thickening and hardening of the wall and 6% were polypoid. In 12%, mucosa adjacent to the tumor revealed squamous metaplasia. All pure squamous cell carcinomas had prominent keratinization. Giant cells and tumor-infiltrating eosinophils were observed in 29 and 51% of the squamous cell carcinomas/adenosquamous carcinomas versus 10% (P ¼ 0.02) and 6% (P ¼ 0.001) in gallbladder adenocarcinomas, respectively. All but three cases had 'advanced' (pT2 and above) carcinomas. Follow-up was available in 31 patients: 25 died of disease (median ¼ 5 months, range 0-20), and 6 were alive (median ¼ 64 months, range 5-112.5). The survival of patients with squamous cell carcinomas/adenosquamous carcinomas was significantly worse than that of gallbladder adenocarcinomas (P ¼ 0.003), and this adverse prognosis persisted when compared with stage-matched advanced gallbladder adenocarcinoma cases (median ¼ 11.4 months, P ¼ 0.01). In conclusion, squamous differentiation was noted in 7% of gallbladder carcinomas. The incidence of adenosquamous carcinoma (defined as 25-99% of the tumor being squamous) was 4%, and that of pure squamous cell carcinoma (without any documented invasive glandular component) was 1%. Pure squamous cell carcinomas often showed prominent keratinization. The overall prognosis of adenosquamous carcinoma/squamous cell carcinoma appears to be even worse than that of ordinary adenocarcinomas. Most patients died within a few months; however, those few who were alive beyond 2 years in this cohort experienced long-term survival.

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Metaplastic breast cancer: clinical significance

Cited by 143 publications

References 38 publications

Breast Carcinosarcomas

Breast Carcinosarcomas

Squamous cell and adenosquamous carcinomas of the gallbladder: clinicopathological analysis of 34 cases identified in 606 carcinomas

Gallbladder Squamous Cell Carcinoma with Chronic Right Upper Quadrant Discomfort

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