Case of the month - February 2007 - discussion

• This carcinoma was originally described in juvenile females



• More recently it has been recognized in adults



• The histological appearances with nested and papillary areas is typical of the lesion



• Note the apocrine-like features of the tumour cells with a prominent central nucleolus



• The presence of PAS positive luminal and cytoplasmic secretion is also typical



• The above features were confirmed in the subsequent excision biopsy. The axillary node sample was negative

Immunoprofile:

• These tumours are also typically S100 positive and gross cystic disease fluid protein & CEA negative



• The immunostaining pattern with CK 5/6 has not been described previously

Prognosis:

• The prognosis in juveniles is said to be good - reported series have relatively small numbers



• Lymph node metastases in adults have been described in 50% of cases reported - but case numbers are very small

Differential diagnosis:

• Apocrine carcinoma
• Glycogen-rich carcinoma
• Lipid-rich carcinoma

Acknowledgement:

I am extremely grateful to Dr Sarah Pinder whom I consulted on this case

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