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Table of Contents
Terminology | Epidemiology | Clinical features | Case reports | Treatment | Gross description | Gross images | Microscopic (histologic) images | Virtual slides | Positive stains | Negative stainsCite this page: Intracystic (encysted) papillary carcinoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/breastmalignantintracysticpapillary.html. Accessed July 14th, 2017.
Terminology
- Also called encapsulated papillary carcinoma, intracystic papillary ductal carcinoma in situ
Epidemiology
- Rare; usually seen in elderly women
- 0.5% - 1% of all breast cancers
- May be associated with conventional DCIS or invasive carcinoma
Clinical features
- Asymptomatic or presents as breast mass or nipple discharge
- Benign appearance on imaging; on ultrasonography, pure cyst, mixed image or solid mass
- Can be divided into pure form and those associated with ductal carcinoma in situ (DCIS) or invasive carcinoma
- Considered noninvasive or minimally invasive, because there is no infiltrating growth pattern and metastases are rare
- Traditionally considered to lack a myoepithelial layer (Am J Clin Pathol 2005;123:36), but one study found expression of type IV collagen (Am J Clin Pathol 2009;131:228)
- More difficult to diagnose preoperatively than other breast tumors (Surg Today 2009;39:5)
- Pseudoinvasion may be due to prior core biopsy causing epithelial displacement (J Clin Pathol 2002;55:780)
Case reports
- 44 year old man with intracystic papillary carcinoma in a male as a rare presentation of breast cancer (J Med Case Rep 2009;3:13)
- 58 year old woman with solid variant of a pure intracystic papillary carcinoma of the breast (Eur J Gynaecol Oncol 2008;29:545)
- 64 year old man with intracystic invasive papillary carcinoma of the male breast with analyses of loss of heterozygosity on chromosome 16q (Breast Cancer 2010;17:146)
- Metastatic potential of encapsulated (intracystic) papillary carcinoma of the breast (Int J Surg Pathol 2007;15:143)
- Intracystic papillary carcinoma of the breast: report of three cases (Case Rep Obstet Gynecol 2012;2012:979563)
Treatment
- Favorable prognosis (Am J Surg Pathol 2006;30:1002), even with invasion (Cancer 2008;113:916, Hum Pathol 1998;29:1097)
- Stromal invasion in 92% with high nuclear grade, frequent mitotic activity, cyclin D1+ or p53+ (Breast J 2005;11:2)
- Treatment is similar to that of DCIS (Am J Surg Pathol 2006;30:1002), namely excision, with possible adjuvant radiation or endocrine therapy (Am J Surg 2007;194:497)
Gross description
- Mural nodule within a large cystic space; may be encapsulated
Gross images
Images hosted on other servers:
Intracystic hemorrhagic tumor with invasion
Microscopic (histologic) images
Images hosted on other servers:
Papillary tumors
Encapsulated tumor with hemorrhage
Papillary and solid pattern of atypical cells
Core biopsy with luminal calcifications
CK 5 / 6 negative
Pseudoinvasion due to epithelial displacement post biopsy
Virtual slides
Images hosted on other servers:
Intracystic papillary carcinoma
Positive stains
- Type IV collagen in one study (Am J Clin Pathol 2009;131:228)
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