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Breast neoplasm with distinct histological subtypes: A case report

2023; Brazilian Society of Mastology; Linguagem: Inglês

10.29289/259453942023v33s1048

2594-5408

Rosana Zabulon Feijó Belluco, Carolina Gaze Gonçalves Fontenele Gomes, Camila Pires Marinho, Renata Betelli Cardoso Alves, Geovanna Sabóia Veras, Júllia Eduarda Feijó Belluco, Flávio Lúcio Vasconcelos, Carmélia Matos Santiago Reis,

HER2/EGFR in Cancer Research

Introduction: Breast cancer is a heterogeneous disease, divided into many subtypes, the most common being invasive ductal. Breast tumors can be derived from epithelial tissue or mesenchymal cells. Most malignant breast tumors are made up of a single type of tumor. Cases where there are two or more types of malignant tumors occurring at the same time are rare. We report a case with different types of malignancies, i.e., non-special invasive ductal carcinoma, metaplastic carcinoma, and squamous cell carcinoma occurred together. Case report: A woman, 56 years old, with no family history of gynecological neoplasia, sought care referring to a painful and erythematous nodule in her left breast for about 25 days. On physical examination, a 15×11 cm, slightly mobile nodule with irregular borders was noticed in the left breast and palpable axillary lymph nodes. The mammogram showed an isodense nodule with internal calcifications, measuring 10.2×9.4×7.2 cm, in the superolateral quadrant (QSL) of the left breast (ME) — BI-RADS V. The central biopsy showed nonspecial invasive breast carcinoma (NOS), triple-negative, and KI67 30%. She underwent neoadjuvant chemotherapy, and 5 months after the start, she showed evidence of tumor progression. The tumor was ulcerated and occupying the entire QSL of ME and on palpation of the armpit, multiple hardened lymph nodes on the left. Left radical mastectomy with axillary lymphadenectomy was performed. The anatomopathological examination of the specific specimen revealed different tumor types: ulcerated and moderately differentiated squamous cell carcinoma, invasive metaplastic breast carcinoma, with a negative immunohistochemical profile for RP, ER, and HER2, positive cytokeratin 7, and 70% Ki67. Two months after the mastectomy, she had tumor recurrence and underwent a new surgical approach. Plastron histopathology showed squamous cell carcinoma infiltrating skin, negative estrogen and progesterone receptors, and positive p63. She underwent radiotherapy and is currently being followed up, with no signs of recurrence.