J Breast Cancer.  2018 Jun;21(2):227-230. 10.4048/jbc.2018.21.2.227.

Apocrine Encapsulated Papillary Carcinoma of the Breast: The First Reported Case with an Infiltrative Component

• KÅ‘vári B
• Ormándi K
• Simonka Z
• Vörös A
• Cserni G

• KMID: 2413943
• DOI: http://doi.org/10.4048/jbc.2018.21.2.227

Abstract

Apocrine encapsulated papillary carcinoma (EPC) of the breast is a rare neoplasm, and only 10 cases have been reported in the literature to date. Although EPC by definition lacks a peripheral myoepithelial layer, all previously published apocrine EPC cases were clinically indolent and lacked a conventional invasive component. Herein, we report the 11th case of apocrine EPC, which had a conventional invasive carcinoma component and provides evidence of the malignant potential of this entity. We postulate that apocrine EPC is most likely a morphological variant of conventional EPC, with the same unpredictable malignant potential as non-apocrine cases.

Keyword

Apocrine glands; Breast neoplasms; Cysts; Papillary carcinoma

MeSH Terms

Apocrine Glands
Breast Neoplasms
Breast*
Carcinoma, Papillary*

Figure

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  Figure 1 Imaging and gross findings. Architecture of the dual tumor with mammography (A), pneumocystography (B), ultrasound (C), and gross morphology (D). Note the sharply outlined component, showing a clear cystic nature (B, C) with an intraluminal mass. In connection with the intracystic tumor an ill-defined lesion with coarse microcalcifications (A) suggestive of an infiltrative tumor component is also present.

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  Figure 2 Histological characteristics and immunoprofile. (A) An intracystic papillary component (right) is surrounded by a thick fibrous capsule and an invasive carcinoma (left) component on the low-power view of the lesion (H&E stain, ×1.2). (B) The intracystic part shows a prominent papillary architecture and apocrine cytomorphology (H&E stain, ×5). (C) The invasive carcinoma part also demonstrates apocrine cytomorphology (H&E stain, ×20). The p63 (D, H&E stain, ×5), cytokeratin 5 (E, H&E stain, ×5), and CD10 (F, H&E stain, ×5) immunohistochemistry markers demonstrate the absence of myoepithelial cells in the intracystic papillary component; note the positive internal control and the focal luminal CD10 expression (insert) frequently observed in apocrine lesions [13]. As an evidence for apocrine differentiation, both the encapsulated papillary carcinoma component (G-I, ×15) and the invasive component (J-L, ×20) express androgen receptor (G and J, respectively), gross cystic disease fluid protein 15 (H and K, respectively), and growth hormone-releasing hormone-receptor (I and L, respectively).

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