Yonsei Med J.  2006 Apr;47(2):259-263. 10.3349/ymj.2006.47.2.259.

Metaplastic Carcinoma with Extensive Chondroid Differentiation in the Breast (Chondroid Carcinoma)

• Kim YJ
• Shim HS
• Lee H
• Jung WH

• KMID: 1110752
• DOI: http://doi.org/10.3349/ymj.2006.47.2.259

Abstract

Metaplastic breast carcinoma is very rare, and metaplastic carcinoma with chondroid differentiation is even rarer. Here, we report a case of metaplastic carcinoma with extensive chondroid differentiation mimicking chondrosarcoma that was challenging to diagnose. The tumor was characterized by an abundant chondromyxoid matrix. The definitive area of classic invasive ductal carcinoma was minimal. The peripheral portion of the tumor showed increased cellularity with pleomorphism and definitive invasive growth. Tumor cells in the chondrosarcomatous areas were diffusely immunoreactive for S-100 protein, patchy positive for cytokeratin, but negative for epithelial membrane antigen (EMA). Tumor cells in carcinomatous areas were diffusely positive for cytokeratin, S-100 protein, and patchy positive for EMA. In both areas, tumor cells were negative for smooth muscle actin (SMA) and CD34, while oncoprotein p53 was overexpressed. When pathologists encounter breast tumors with chondroid differentiation, careful sampling and immunohistochemistry for cytokeratin and SMA are most helpful to differentiate metaplastic carcinoma from malignant phyllodes tumor and malignant adenomyoepithelioma.

Keyword

Breast; carcinoma; metaplasia; cartilage; immunohistochemistry

MeSH Terms

S100 Proteins/chemistry
Neoplasm Metastasis
Muscle, Smooth/pathology
Middle Aged
Metaplasia
Keratins/metabolism
Immunohistochemistry
Humans
Female
Cell Differentiation
Carcinoma/*complications/metabolism/pathology
CA-15-3 Antigen/metabolism
Breast Neoplasms/complications/metabolism/*pathology
Antigens, CD34/biosynthesis
Actins/metabolism

Figure

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  Fig. 1 The tumor cells grow in highly infiltrative pattern. In that carcinomatous area (A), the tumor cells are diffusely positive for cytokeratin (B).

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  Fig. 2 The tumor shows extensive chondroid matrix with perinuclear halo (A). In that chondrosarcomatous area, the tumor cells are patchy-positive for cytokeratin (B).

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  Fig. 3 Immunostaining shows diffuse positive reactivity with S-100 protein (A), but negativity with smooth muscle actin (B).

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