Breast – Malignant, Males, Children - Mucinous cystadenocarcinoma and columnar cell mucinous carcinoma

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Breast-malignant, males, children

Mucinous cystadenocarcinoma and columnar cell mucinous carcinoma

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

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

Revised: 17 September 2009

Last major update: September 2009

Definition

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● Very rare as primary breast tumor (<50 cases reported)

● Carcinoma composed of tall columnar cells with basal, bland nuclei and abundant intracytoplasmic mucin

● Either grossly cystic (mucinous cystadenocarcinoma) or solid (columnar cell mucinous carcinoma)

● Resembles similar tumors of ovary, pancreas and appendix (AJSP 1998;22:698)

Epidemiology

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● Mean age 58-68 years, range 49-96 years

Case reports

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● 65 year old woman whose tumor coexisted with infiltrating ductal carcinoma (Pathol Int 2004;54:781)

● 96 year old woman (Archives 2003;127:1031)

Gross description

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● Multicystic, up to 19 cm

● Resembles ovarian and pancreatic cystadenocarcinoma, cystic hypersecretory carcinoma of breast

Gross images

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Ovary - multicystic tumor

Microscopic description

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● Cystic spaces lined by bland, tall columnar cells with abundant intracytoplasmic mucin

● Tumor cells exhibit stratification, tufting and papillary formation

● Variable cytologic atypia

● Gradual loss of intracytoplasmic mucin and transformation to eosinophilic squamoid cells that are focally invasive

● Columnar cell variant has round and convoluted glands in loose aggregates, lined by tall columnar mucinous epithelium with basal bland nuclei

Micro images

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Breast-various images Retroperitoneal tumor

Positive stains

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● CK7, Ki-67 (high % of cells)

Negative stains

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● CK20, ER, PR

Differential diagnosis

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● Colloid/mucinous carcinoma - clusters of tumor cells floating in lakes of extracellular mucin

● Cystic hypersecretory carcinoma - prominent epithelial hyperplasia and eosinophilic secretions

● Metastatic tumor

End of Breast – Malignant, Males, Children > Mucinous cystadenocarcinoma and columnar cell mucinous carcinoma

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