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Breast malignant, males, children

Carcinoma subtypes

Sebaceous carcinoma


Reviewer: Monika Roychowdhury, M.D. (see Reviewers page)
Revised: 5 May 2014, last major update August 2012
Copyright: (c) 2001-2012, PathologyOutlines.com, Inc.

Definition
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● Very rare primary breast carcinoma resembling skin adnexal tumor with sebaceous differentiation, but no evidence of cutaneous derivation (see J Med Case Rep 2008;2:276 for cutaneous tumor of breast)

Clinical features
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● Associated with Muir-Torre syndrome (Cancer 2005;103:1018)

Case reports
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● 45 year old woman with extensive metastatic disease (Pathol Int 2000;50:63)
● 46 year old woman with Muir-Torre syndrome (AJR Am J Roentgenol 2000;174:541)
● 50 year old woman (Pathol Int 2009;59:188)
● 63 year old woman (Virchows Arch 2006;449:484)
● 83 year old woman with tumor of nipple (J Cutan Pathol 2008;35:608)

Micro description
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● Well-defined solid sheets or lobules of atypical epithelial cells, including large, pale or clear cells with coarsely vacuolated cytoplasm, containing Oil red O staining lipid and often scalloped nuclei
● Often focal squamous morules

Micro images
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Malignant cells with sebaceous gland differentiation.


Focal calcification and necrosis


Contributed by Dr. Semir Vranic, University of Sarajevo (Bosnia)

Conjunctiva:

Sebaceous carcinoma

Skin:

Various images

Positive stains
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● Cytokeratin, including 35betaH11 (Pathol Res Pract 1993;189:888), EMA
● ER, PR, Oil Red O
● Mismatch repair genes: MLH1, PMS2, MSH2, MSH6 (Ceska Gynekol 2010;75:50)
● Some cells may express neuroendocrine markers

Negative stains
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● GCDFP-15, CEA, S100 and vimentin
● Alpha smooth muscle actin, p63, androgen receptor (usually), mucins, HER2 and CK15

Electron microscopy description
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● Empty appearing, non-membrane bound vacuoles

Differential diagnosis
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Apocrine carcinoma: >90% of tumor cells have cytologic or immunohistochemical features of apocrine cells
Lipid rich carcinoma: usually not coarsely vacuolated, often squamous morules, usually HER2+, ER-, PR-

End of Breast malignant, males, children > Carcinoma subtypes > Sebaceous carcinoma


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