Metaplastic carcinoma of the breast with heterologous mesen-chymal (neuroectodermal) differentiation: a clinicopathological analysis and literature review.
10.3724/zdxbyxb-2025-0264
- Author:
Xiaolin WANG
1
,
2
;
Kai WANG
3
;
Yajian WANG
3
;
Hongyan WANG
2
,
4
Author Information
1. Department of Pathology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China. 18435149409@
2. com.
3. Department of Pathology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China.
4. Department of Pathology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China. whycc0320@
- Publication Type:English Abstract
- Keywords:
Breast metaplastic carcinoma;
Case report;
Clini-copathological features;
Differential diagnosis;
Neuroectodermal differentiation
- MeSH:
Humans;
Female;
Adult;
Breast Neoplasms/pathology*
- From:
Journal of Zhejiang University. Medical sciences
2025;54(4):559-565
- CountryChina
- Language:Chinese
-
Abstract:
A 32-year-old woman presented with a progressively enlarging left breast mass for about one year. Breast magnetic resonance imaging (MRI) revealed a mass at the 9 o'clock position in the left breast, classified as BI-RADS category 6. The patient underwent endoscopic left breast-conserving surgery and sentinel lymph node biopsy. Histological examination (HE staining) revealed a tumor composed of sheets of epithelioid cells and fascicles of spindle cells, with areas of transition between the two components. Epithelioid cells were small, round to short-spindled, with scant cytoplasm, crowded arrangement, and coarse chromatin. Spindle cells were loosely arranged with indistinct borders, mildly eosinophilic cytoplasm, inconspicuous nucleoli, and intervening pale pink matrix. Immunohistochemistry demonstrated: epithelioid cells were diffusely positive for CK8/18, CAM5.2 and E-cadherin; partially positive for pan-CK and CK7; focally positive for CK5/6, CK14, high molecular weight cytokeratin and P63; and negative for vimentin. Spindle cells were positive for synaptophysin, CD56 and vimentin, and for glial fibrillary acidic protein, but negative for epithelial markers (pan-CK, CK7, CK8/18, CAM5.2, E-cadherin). The diagnosis was metaplastic carcinoma with heterologous mesenchymal (neuroectodermal) differentiation. Postoperatively, the patient received 8 cycles of EC-T systemic chemotherapy. Follow-up with breast MRI and chest CT every 3 months for 23 months showed no evidence of tumor recurrence or metastasis.
