Tall Cell Carcinoma With Reversed Polarity of the Breast

Abstract

Tall cell carcinoma with reversed polarity (TCCRP) of the breast is a rare entity with low potential for malignancy that exhibits some morphological similarities to the tall cell variant of papillary thyroid carcinoma. Immunohistochemical and molecular studies help establish the mammary origin of this neoplasm. Here, we describe the case of a 63-year-old woman with a finding of a nodular lesion during a screening mammogram, whose morphological findings and immunohistochemical studies confirmed the diagnosis of papillary high cell carcinoma with the reverse polarity of the mammary gland.

Tall cell carcinoma with reversed polarity of breast: Sonographic and magnetic resonance imaging findings

“…Immunohistochemically, TCCRP typically shows the ER and PR negative and c‐erb‐2/HER‐2 negative phenotype, so‐called triple negative. Some of the reported cases showed weak or focal hormone receptor expression but almost all reported cases were HER‐2 negative 5–7 . TCCRP also shows negative myoepithelial markers and intense reactivity for high weight cytokeratins (CK5/6).…”

“…6 The clinical manifestation of TCCRP can vary; however, it is commonly diagnosed through a palpable breast mass or incidental finding on screening mammography. 5 The size of the tumors ranges from 6 to 55 mm at the time of diagnosis. 7 The radiologic findings of TCCRP present as a mammographic mass and ultrasound reveals a hypoechoic mass with or without posterior shadowing.…”

“…Usually Ki‐67 index of the tumor is less than 20%, which are low or intermediate grade tumors 1,5,6,8 . TTF1 and thyroglobulin negativity can rule out thyroid papillary carcinoma metastasis 5,8 . TCCRP is frequently associated with specific IDH2 and PIK3CA mutations 4 .…”

“…It usually occurs in postmenopausal women with an average age of 64 years, ranges from 39 to 89 6 . The clinical manifestation of TCCRP can vary; however, it is commonly diagnosed through a palpable breast mass or incidental finding on screening mammography 5 . The size of the tumors ranges from 6 to 55 mm at the time of diagnosis 7 …”

“…Some of the reported cases showed weak or focal hormone receptor expression but almost all reported cases were HER-2 negative. [5][6][7] TCCRP also shows negative myoepithelial markers and intense reactivity for high weight cytokeratins (CK5/6). Usually Ki-67 index of the tumor is less than 20%, which are low or intermediate grade tumors.…”