Neuroendocrine differentiation in pure type mammary mucinous carcinoma is associated with favorable histologic and immunohistochemical parameters

Abstract

Mucinous carcinoma of the breast is a specific good prognostic type malignancy occurring in elderly patients. Neuroendocrine differentiation has long been described in mucinous carcinoma, but the significance of such finding is uncertain. We evaluated the neuroendocrine differentiation profiles of 38 cases of pure mucinous carcinoma and compared the clinicopathological differences between those with and those without neuroendocrine differentiation. The parameters assessed included patients' age, tumor size, nuclear grade, axillary lymph node status at time of diagnosis, percentage area of intratumoral mucin, and the expression of estrogen and progesterone receptors, cerbB2 oncoprotein, and three neuroendocrine markers, namely neurone-specific enolase, chromogranin, and synaptophysin by immunohistochemistry. Patients' outcome and follow-up period were also documented. Of the 38 cases of pure mucinous carcinoma, 28, 11 and six cases showed positive staining for 1, 2 and 3 of the neuroendocrine markers. For all the groups with variable neuroendocrine differentiation and compared to those without such differentiation, they all showed older patients' age, higher proportion of tumors with lower nuclear grade, lower incidence of axillary lymph node metastasis, a higher progesterone receptor, and lower cerbB2 oncoprotein expression. No difference was detected between tumor size, intratumoral mucinous area, and estrogen receptor status. In all, 37 patients did not have distant metastases or local recurrences at the end of follow-up period, while one patient with coexisting high-grade ductal carcinoma in situ at time of diagnosis died of breast carcinoma. Our findings suggest that the identification of neuroendocrine differentiation in pure mucinous carcinoma is associated with more favorable histologic and immunohistochemical parameters.

Mucinous Carcinoma with Neuroendocrine Differentiation of Salivary Gland Origin

“…[15] However, WT-1 expression was negative in this specimen, arguing against an EMPSGC diagnosis. The described case is unusual in that it exhibits morphologic and immunohistochemical features similar to primary mammary mucinous adenocarcinomas, with neuroendocrine differentiation [16] in its receptor profile and GATA-3 positivity. Studies of chromogranin and synaptophysin are lacking in cases of salivary gland carcinomas, though positivity of neuron-specific enolase and glial fibrillary acid protein has been reported in a mucin-rich salivary gland carcinoma [17].…”

A Case of Primary Cutaneous Mucinous Carcinoma with Neuroendocrine Differentiation

“…Two previous studies suggested that mucinous carcinoma of breast showing neuroendocrine differentiation had a good prognosis 18,19 . And these groups were characterized by older patient age, and were associated with more favorable histologic and immunohistochemical parameters including lower tumor nuclear grade, lower incidence of axillary lymph node metastasis, and lower cerbB2 oncoprotein expression 18 . In a study regarding mucin-producing sweat gland carcinoma, neuroendocrine differentiation was associated with good prognosis 20 .…”

“…A group of human breast carcinomas show histochemical evidence of neuroendocrine differentiation. Neuroendocrine differentiation of mucinous carcinoma of the breast has been reported since 1980, with the tumor being classified as type A (without neuroendocrine differentiation), type B (with neuroendocrine differentiation) and type AB (the intermediate form) 18 .…”

Carcinoma mucinoso invasor da mama e seus diagnósticos diferenciais em biópsia por agulha grossa: revisão da literatura

“…Esses carcinomas podem apresentar diferenciação neuroendócrina, a qual pode ser avaliada pelo método imunohistoquímico com os marcadores enolase, sinaptofisina e cromogranina (23) . Tse et al classificaram os carcinomas mucinosos em três tipos, conforme grau de diferenciação: A (sem diferenciação), B (com diferenciação) e AB (forma intermediária entre A e B).…”