Author: Maurice Y.M.M.; Azhar U.; Kamla Sidky K.S.
Abstract: This is an unusual variant of metaplastic carcinoma of breast. Only sporadic cases have come to light since this entity was defined in 1986. The acantholytic variant of squamous cell carcinoma is characterized by the formation of irregular spaces lined by atypical squamous cells leading to a pseudoglandular or pseudoangiosarcomatous appearance. It should be considered as a potential differential diagnosis with angiosarcoma. We present a case of acantholytic/pseudoangiosarcomatous carcinoma of the breast in a 65 year old lady who presented with a palpable mass in her left breast. A core biopsy demonstrated a malignant neoplasm composed of anastomosing channels lined by spindle shaped cells in a densely collagenous stroma with focal myxoid areas. The diagnosis was made after immunohistochemistry demonstrated the epithelial nature of the neoplasm and endothelial markers were negative. Immunohistochemical analysis of metaplastic carcinomas has revealed that >90% of these cancers are negative for ER, PR and HER2, and express keratins CK5/6 and 14, and EGFR. Awareness and subsequent recognition of this specific variant of metaplastic carcinoma is important to prevent misdiagnosis and allow proper treatment.
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