Breast
Invasive breast carcinoma of no special type and variants
Choriocarcinomatous


Topic Completed: 1 October 2012

Minor changes: 21 June 2020

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PubMed Search: Carcinoma with choriocarcinomatous features

Monika Roychowdhury, M.D.
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Page views in 2020 to date: 895
Cite this page: Roychowdhury M. Choriocarcinomatous. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/breastmalignantductalNOSchoriocarcinomatous.html. Accessed November 23rd, 2020.
Definition / general
  • Rare tumor (< 50 cases reported) with choriocarcinomatous differentiation, first described in 1981 (Am J Surg Pathol 1981;5:773, Arch Pathol Lab Med 2011;135:1097)
  • Histologic origin of syncytiotrophoblastic cells is unclear - most plausible theory is metaplastic process
  • Part of WHO classification
  • Often elevated serum beta-hCG (although nonspecific)
Clinical features
  • Rapidly growing palpable mass indistinguishable from conventional breast carcinoma
  • Usually characterized by locally advanced disease and poor prognosis
Case reports
Treatment
  • Usually surgical resection; chemotherapeutic regimen unclear since tumor is rare
Gross description
  • Tumor size ranges from 1 - 10 cm
  • Cut surface may be hemorrhagic
  • Skin ulceration may be present and correlates with size and advanced stage
Microscopic (histologic) description
  • Markedly pleomorphic multinucleated choriocarcinomatous cells with abundant eosinophilic cytoplasm and occasional cytoplasmic vacuoles
  • Associated with ductal carcinoma in situ, invasive ductal carcinoma, and frank metaplastic carcinoma with distinctive heterologous components or sarcomatoid areas
Microscopic (histologic) images

Case of the Week #306





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Metaplastic carcinoma with areas of choriocarcinomatous differentiation

Cytology description
  • Abundant multinucleated giant cells with highly pleomorphic tumor cells in a hemorrhagic necrotic background (Acta Cytol 2008;52:99)
Positive stains
Negative stains
  • Giant cells: ER / PR (usually)
Differential diagnosis
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