Tall Cell Carcinoma with Reversed Polarity:Case Report of a Rare Special Type of Breast Cancer and Review of the Literature

Background: Tall cell carcinoma of the breast with reversed polarity (TCCRP) is a rare type of invasive breast cancer with overlapping features with papillary thyroid carcinoma and a characteristic molecular profile. Few cases have been reported in the literature since the first case was described in 2003. Case presentation: We present the case of a 41-year-old female with a symptomatic left breast lump. Image-guided core biopsy was diagnosed as triple-negative apocrine carcinoma. Surgical excision revealed an invasive carcinoma with solid papillary pattern, nuclei arranged away from the basement membrane (reversed polarity) and luminal eosinophilic colloid-like material. The tumour was GATA3-, CK5-, CK14- and CK7-positive and TTF1-negative. Specialist opinion and the identification of hotspot mutations in the IDH2 p.Arg172 gene via PCR confirmed the diagnosis of TCCRP. Conclusions: TCCRP is a relatively recently recognised papillary epithelial neoplasm with characteristic morphological features and molecular profile. Due to its rarity, TCCRP can be diagnostically challenging, and features can be mistaken for benign and malignant lesions. Accurate diagnosis is important in effective treatment of this indolent malignant triple-negative breast cancer, which carries an excellent prognosis

Profiling of Tumour-Infiltrating Lymphocytes and Tumour-Associated Macrophages in Ovarian Epithelial Cancer:Relation to Tumour Characteristics and Impact on Prognosis

Early evidence suggests a strong impact of tumour-infiltrating lymphocytes (TILs) on both the prognosis and clinical behaviour of ovarian cancer. Proven associations, however, have not yet translated to successful immunotherapies and further work in the field is urgently needed. We aimed to analyse the tumour microenvironment of a well-characterised cohort of ovarian cancer samples. Tumour markers were selected owing to their comparative underrepresentation in the current literature. Paraffin-embedded, formalin-fixed tumour tissue blocks of 138 patients representative of the population and including early stage disease were identified, stained for CD3, CD20, CD68 and CD163 and analysed for both the stromal and intertumoral components. Data were statistically analysed in relation to clinical details, histological subtype, borderline vs. malignant status, survival and management received. Mean stromal CD3, total CD3 count, mean stromal CD20 and total CD20 count all correlated negatively with survival. Malignant ovarian tumours consistently demonstrated significantly higher infiltration of all analysed immune cells than borderline tumours. Assessment of the stromal compartment produced a considerably higher proportion of significant results when compared to the intra-tumoural infiltrates. Customary assessment of solely intra-tumoural cells in advanced stage disease patients undergoing primary debulking surgery should be challenged, with recommendations for future scoring systems provided

Comparative study on four spectrophotometric methods manipulating ratio spectra for the simultaneous determination of binary mixture of diflucortolone valerate and isoconazole nitrate

Four simple, accurate, reproducible and non-sophisticated spectrophotometric methods manipulating ratio spectra were developed and validated for the simultaneous determination of diflucortolone valerate (DIF) and isoconazole nitrate (ISO) without preliminary separation in pure powder form and in their cream formulation. Method A, is constant center spectrophotometric method (CC), method B is a ratio difference spectrophotometric one (RD), method C is the first derivative of the ratio spectra (1DD), while method D is the mean centering of ratio spectra (MC). Linearity correlations ranges were 5–60 μg mL−1 for DIF and 65–850 μg mL−1 for ISO. The mean percentage recoveries of DIF were 101.60 ± 1.056 for method A, 101.33 ± 0.702 for method B, 101.31 ± 1.476 for method C and 102.69 ± 1.009 for method D, respectively. For ISO were 100.59 ± 0.525 for method A, 99.68 ± 0.721 for method B, 99.67 ± 0.742 for method C and 101.37 ± 0.958 for method D, respectively. Assessment of the specificity was achieved by analyzing synthetic mixtures containing the cited drugs. The four methods were applied for the determination of the cited drugs in cream formulation and the statistical comparison of the obtained results was made with each other and with those of official methods. The comparison in pure powder form showed that there is no significant difference between the proposed methods and the official methods regarding both accuracy and precision

Radiation-Associated Primary Osteosarcoma of the Breast.

INTRODUCTION Non-epithelial primary mammary osteosarcomas are extremely rare. The differentials include metaplastic carcinoma and malignant phyllodes tumour. This is the first published case of primary breast osteosarcoma arising after local radiotherapy. CASE PRESENTATION A 73-year-old female presented with a right-sided breast lump. The same breast had been irradiated 11 years previously for invasive ductal carcinoma. Diagnostic excision revealed a highly cellular, malignant spindle-cell lesion merged with an osteoid matrix and foci of calcification and bone formation. Immunohistochemistry and molecular studies showed no lines of differentiation. Due to the lack of epithelial/glandular differentiation, in situ carcinoma or leaf-like pattern, the diagnosis of post-irradiation osteosarcoma was made. She underwent mastectomy and is disease-free at 8 months of follow-up. CONCLUSION Post-irradiation osteosarcoma should be considered in the differential diagnosis of breast lesions showing malignant osteoid. Extensive sampling and careful search for epithelial differentiation is required to guide management. Complete surgical excision is recommended

Unusual Presentation of Mammary Calciphylaxis in a Patient on Long-Standing Renal Dialysis.

INTRODUCTION Calciphylaxis is a condition which involves ectopic deposition of calcium in arterioles of various organ systems. Here, we present a rare case of mammographic calcifications in a patient on long-standing renal dialysis. CASE This is a 57-year-old female who presented to breast clinic with unilateral severe pain and lumpiness of her breast. On mammography, calcifications were identified which were associated with focal lesions on ultrasound. An image-guided core biopsy showed numerous foci of histological calcification within a large area of fat necrosis. The location within arterioles was confirmed by CD31 immunohistochemistry. The diagnosis of fat necrosis with benign calcifications due to mammary calciphylaxis was made. CONCLUSION The hallmark of calciphylaxis is the deposition of calcium within small- to medium-sized vessel walls. This leads to ischaemia and necrosis of tissue. In the breast, only a few cases were reported in which patients presented with a necrotic lesion resembling carcinoma. These are reviewed in this report