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Breast malignant, males, children

Carcinoma subtypes

Metaplastic carcinoma - spindle cell subtype


Reviewer: Monika Roychowdhury, M.D. (see Reviewers page)
Revised: 2 October 2012, last major update October 2012
Copyright: (c) 2001-2012, PathologyOutlines.com, Inc.

Definition
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● Sarcomatoid morphology, plus either limited (< 5%) invasive carcinoma component or keratin positive sarcoma component (Am J Surg Pathol 2005;29:1456)
● Excludes low grade fibromatosis-like metaplastic tumors
Note: some cases called spindle cell carcinoma in the literature have > 5% invasive carcinoma component

Terminology
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● Also called sarcomatoid carcinoma or spindle cell carcinoma

Clinical features
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● Sarcoma-like behavior (Am J Surg Pathol 2005;29:1456)
● Aggressive, high rate of local relapse and extranodal metastases
● Rate of nodal metastases varies from minimal (Am J Surg Pathol 2006;30:300) to 40% (Eur J Surg Oncol 2003;29:600)

Case reports
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● 80 year old woman with a single, palpable irregular breast mass (Univ Pittsburgh Case #294)
● 84 year old woman with triple negative mixed metaplastic breast carcinoma with squamous and spindle cells (BMJ Case Rep 2012 Feb 25)
● Woman with spindle cell carcinoma of the breast (Breast Dis 2012 Mar 29 [Epub ahead of print])

Micro images
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Spindle cell stroma

       
Various images

Positive stains
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● 34betaE12 (60%), SMA (56%, Hum Pathol 2003;34:1009) and p53
● Wide-spectrum keratin screening recommended since variable staining for CK5, CK14, Cam5.2 and AE1/AE3 (Histopathology 2002;40:556)
● Variable S100

Negative stains
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● Usually ER, PR and HER2 (J Clin Pathol 2006;59:1079)
● CD34, bcl2

End of Breast malignant, males, children > Carcinoma subtypes > Metaplastic carcinoma - spindle cell subtype


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