Advertisement
Advertisement
Table of Contents
Definition / general | Clinical features | Case reports | Treatment | Gross description | Microscopic (histologic) description | Microscopic (histologic) images | Cytology description | Positive stains | Negative stains | Differential diagnosisCite this page: Ductal carcinoma, NOS - Carcinoma with choriocarcinomatous features. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/breastmalignantductalNOSchoriocarcinomatous.html. Accessed July 14th, 2017.
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
- 37 year old woman had a biopsy with an unspecified breast malignancy (Case of the Week #306)
- Two cases (Ann Diagn Pathol 2004;8:74)
- Choriocarcinomatous and neuroendocrine features (Sao Paulo Med J 2001;119:154)
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
Images hosted on PathOut server:
Case of the Week #306
Images hosted on other servers:
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
- Giant cells: human placental lactogen, beta-hCG (Breast J 2002;8:244)
Differential diagnosis
- Metastatic choriocarcinoma to breast: clinically history; no usual type breast carcinoma, no DCIS (AJR Am J Roentgenol 2005;184:S53)
Advertisement
