Breast malignant, males, children - Adenosquamous carcinoma

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Breast malignant, males, children

Carcinoma subtypes

Adenosquamous carcinoma - low grade

Reviewer: Monika Roychowdhury, M.D. (see Reviewers page)
Revised: 18 December 2012, last major update March 2012
Copyright: (c) 2001-2012, PathologyOutlines.com, Inc.

General
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● Carcinoma with well developed tubule/gland formation mixed with widely dispersed solid nests of squamous cells

Terminology
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● Also called syringomatous carcinoma, adenocarcinoma with squamous differentiation
● See also mucoepidermoid carcinoma

Clinical description
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● Uncommon; considered a rare variant of metaplastic breast carcinoma (Am J Surg Pathol 1987;11:351)
● May originate from an intraductal papillary tumor, or be associated with sclerosing adenosis, radial scar or ductal adenoma
● Recurs locally with conservative therapy, metastases unusual
● Difficult to diagnose by fine needle aspiration, core biopsy or frozen section (Histopathology 2006;49:603)

Case reports
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● 19 year old woman (World J Surg Oncol 2010 May 27;8:44)

Gross description
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● Mean 2-3 cm, range 1-9 cm
● Hard, tan-yellow, infiltrative

Gross images
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Well circumscribed mass (AFIP)

Micro description
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● Resembles syringomatous adenoma of nipple; often originates from intraductal papillary tumor
● Has tadpole or comma shaped epithelial structures with inner epithelial cells and outer myoepithelial cells
● Also other areas of obvious squamous differentiation, desmoplastic stroma
● Often keratinizing squamous component

Micro images
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Various images

AFIP Third Series

DCIS in large duct below and at arrows giving rise to adenosquamous carcinoma

Invasive ductal elements with syringomatous features in dense collagenous stroma

Neoplastic ductules around a lobule

Neoplastic ductules with secretion and squamous area

Cytology description
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● Proliferating ductal cells and atypical squamous cells in the same cell clusters (Pathol Int 1997;47:264)

Positive stains
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● Variable myoepithelial marker expression (HHF35, calponin, S100, CK14, CK5/6, p63)
● Positive for CK5, CK17 and CK14 (Mod Pathol 2010;23:951)

Negative stains
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● ER, PR (Pathol Annu 1994;29:181)
● Often triple negative tumors (ER-, PR-, HER2-, Mod Pathol 2010;23:951)

EM description
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● Glandular and squamous differentiation
● Squamous cells resemble acrosyringium of eccrine sweat gland

Differential diagnosis
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● Syringomatous adenoma of nipple: similar histology, but more superficial, involving nipple areolar complex; benign

Additional references
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● Am J Surg Pathol 1993;17:248, Am J Surg Pathol 1987;11:351
● Stanford University, Diagn Cytopathol 2011 Apr 28 [Epub ahead of print]

End of Breast malignant, males, children > Carcinoma subtypes > Adenosquamous carcinoma - low grade

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