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Breast malignant, males, children

Carcinoma subtypes

Mucinous cystadenocarcinoma and columnar cell mucinous carcinoma


Reviewer: Monika Roychowdhury, M.D. (see Reviewers page)
Revised: 6 October 2012, last major update September 2012
Copyright: (c) 2001-2012, PathologyOutlines.com, Inc.

Definition
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● Very rare as primary breast tumor (< 50 cases reported)
● Carcinoma composed of tall columnar cells with basal, bland nuclei and abundant intracytoplasmic and extracytoplasmic mucin (as opposed to mucinous / colloid carcinoma with only extracellular mucin, and signet ring cell carcinoma with only intracellular mucin)
● Either grossly cystic (mucinous cystadenocarcinoma) or solid (columnar cell mucinous carcinoma)
● Resembles similar tumors of ovary, pancreas and appendix (Am J Surg Pathol 1998;22:698)

Epidemiology
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● Mean age 58-68 years, range 49-96 years

Case reports
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● 41 year old woman with a basal-like immunophenotype (Pathol Int 2012;62:429)
● 52 year old woman (Case Rep Oncol 2009;2:210)
● 65 year old woman whose tumor coexisted with infiltrating ductal carcinoma (Pathol Int 2004;54:781)
● 65 year old woman with primary mammary mucinous cystadenocarcinoma (Diagn Cytopathol 2012;40:624)
● 96 year old woman with mucinous cystadenocarcinoma of breast (Arch Pathol Lab Med 2003;127:1031)
● Mucinous cystadenocarcinoma of the breast with Her2 amplification (Hum Pathol 2010;41:910)

Gross description
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● Multicystic, up to 19 cm
● Resembles ovarian and pancreatic cystadenocarcinoma, cystic hypersecretory carcinoma of breast

Gross images
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Ovary - multicystic tumor

Micro description
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● Cystic spaces lined by bland, tall columnar cells with abundant intracytoplasmic mucin
● Tumor cells exhibit stratification, tufting and papillary formation
● Variable cytologic atypia
● Gradual loss of intracytoplasmic mucin and transformation to eosinophilic squamoid cells that are focally invasive
● Columnar cell variant has round and convoluted glands in loose aggregates, lined by tall columnar mucinous epithelium with basal bland nuclei
● Demonstrates both intracellular and extracellular mucin

Micro images
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Mucinous cystadenocarcinoma of breast with estrogen receptor expression


Breast - various images


Retroperitoneal tumor

Positive stains
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● CK7, Ki-67 (high % of cells) and ER (rarely positive, Case Rep Oncol 2009;2:210)

Negative stains
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● CK20, CDX2, ER and PR

Differential diagnosis
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Colloid / mucinous carcinoma: clusters of tumor cells floating in lakes of extracellular mucin
Cystic hypersecretory carcinoma: prominent epithelial hyperplasia and eosinophilic secretions
● Metastatic tumor

End of Breast malignant, males, children > Carcinoma subtypes > Mucinous cystadenocarcinoma and columnar cell mucinous carcinoma


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