Breast – Malignant, Males, Children - Spindle cell subtype of metaplastic carcinoma

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Breast-malignant, males, children

Metaplastic carcinoma - Spindle cell subtype

Author: Nat Pernick, M.D, PathologyOutlines.com, Inc.

Reviewer: Daniel Visscher, M.D., University of Michigan Hospitals, February 2009 (see Reviewers page)

Revised: 27 September 2009

Last major update: September 2009

Definition

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● Sarcomatoid morphology, plus either limited (<5%) invasive carcinoma component or keratin positive sarcoma component (AJSP 2005;29:1456)

● Excludes low grade fibromatosis-like metaplastic tumors

● Note: some cases called spindle cell carcinoma in the literature have >5% invasive carcinoma component

Terminology

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● Also called sarcomatoid carcinoma or spindle cell carcinoma

Clinical

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● Sarcoma-like behavior (AJSP 2005;29:1456)

● Aggressive, high rate of local relapse and extranodal metastases

● Rate of nodal metastases varies from minimal (AJSP 2006;30:300) to 40% (Eur J Surg Oncol 2003;29:600)

Case reports

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● 80 year old woman (Univ Pittsburgh Case #294)

Micro images

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Spindle cell stroma

Various images

Positive stains

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● 34betaE12 (60%), SMA (56%) (Hum Pathol 2003;34:1009), p53

● Wide-spectrum keratin screening recommended since variable staining for CK5, CK14, Cam5.2 and AE1/AE3 (Histopathology 2002;40:556)

● Variable S100

Negative stains

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● Usually ER, PR, HER2 (J Clin Pathol 2006;59:1079), CD34, bcl2

End of Breast – Malignant, Males, Children > Metaplastic carcinoma > Spindle cell subtype

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