Dados do Trabalho

Título

CARCINOMA ADENOIDE QUÍSTICO DE LA MAMA

Título em Inglês

CYSTIC ADENOID CARCINOMA OF THE BREAST

Introdução

Cystic adenoid breast carcinoma (CAQ) is a rare variant that occurs in large series less than 1%. They have favorable prognosis and morphological resemblance to tumors originating in the salivary glands. 1.2 Histopathological diagnosis is based on a mixture of proliferating glands, which corresponds to the adenoid component and the replication of the basal membrane in the form of cylinders established by the pseudoglandular component. It usually occurs in adult women. Its form of clinical presentation is a painless breast nodule, located in the retroareolar region, without compromise of skin or nipple secretion, small size and circumscribed limits. 1-3 Treatment of (CAQ) is not protocolized, although it is accepted that conservative surgery is applicable in most cases.1,4 Our goal is to publicize the clinical case of a patient treated in our service and show some clinical and histopathological aspects of this same rare pathology.

Relato de caso

63-year-old patient, no history of family cancer, menarca:16 years, 3 full births, 24 months of lactation, menopause at 46 years, no hormone replacement. Hypertensive and diabetic, a right breast nodule was self-detected 6 months ago; slow and painless growth that then fistulizes the skin and is accompanied by serohematic secretion of gelatinous consistency. Physical examination, a 7 cm nodule is felt in lower quadrants, elastic consistency and poorly defined edges. No adenopathies in the armpits or neck. The sectional biopsy in another service. Pathological anatomy: differential diagnosis between Hypersecretor Cystic Carcinoma and Secretory Cystic Hyperplasia. With the diagnosis of (CAQ) of the right breast, T2N0Mx stage IIa. Mammography: breasts type b, at the junction of lower quadrants of the right breast, dense delimited mass measuring 5 x 4 cm, no retraction or skin edema. BIRADS V (Figure 1 and 2). Ecograph: A mass located in H6 to 3 cm of the nipple with well delimited edges, with heterogeneous characteristics with liquid and solid areas of 5.71 cm x 4.06 cm. BIRADS V. (Figure 3) is observed. Extensive resection and sentinel node biopsy is performed. (Figures 4 and 5). Histopathological result revealed (CAQ) G1 of 5.5 cm with no associated in situ carcinoma. No vascular plungers or perineural invasion are observed. Free surgical limits. pT3 Nx.Mx. Immunohistochemistry: RE-; RP-; HER2-;ki67<14%. Our case showed a neoplastic proliferation consisting of two types of cavity formation; true glandular lights (adenoid component) and pseudo lumens that produce basal membrane material (cylinder component) with eosinophilic basal membrane material, the adenoid component with basophilic mucin and surrounded by myoepilelial cells. (Figure 6). Three negative lymph nodes metastasis. Radiation therapy was decided as an adjuvant treatment.

Palavras Chave

Carcinoma adenoide quístico; Carcinoma de mama; Carcinoma adenoide quístico; Carcinoma de mama; Carcinoma de mama triple negativo; Carcinoma de mama triple negativo.

Área

DETECTION / DIAGNOSIS - Breast lesion