Grela-Wojewoda, Aleksandra

Lompart, Joanna

Pietruszka, Agnieszka

Puskullouglu, Mirosława

Wysocka, Joanna B.

Via Medica Journals

239Obrazy w onkologii / Pictures in oncologyBreast invasive carcinoma with a choriocarcinomatous patternJoanna B. Wysocka1, Joanna Lompart2, Agnieszka Pietruszka2, Mirosława Puskulluoglu2,  Aleksandra Grela-Wojewoda21Departament of Tumour Pathology, Maria Sklodowska-Curie National Research Institute of Oncology, Krakow Branch, Krakow, Poland 2Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Krakow Branch, Krakow, PolandJak cytować / How to cite:Wysocka JB, Lompart J, Pietruszka A, Puskulluoglu M, Grela-Wojewoda A. Breast invasive carcinoma with a choriocarcinomatous pattern. NOWOTWORY J Oncol 2023; 73: 198. A 36-year old female was diagnosed with a breast infiltrating duct carcinoma, NOS, G2, luminal B HER2-neg, metastatic to the lymph nodes, lungs, liver and bones. She received ribociclib, fulvestrant and LHRH analog for 15 months with partial remission. For personal reasons the patient interrupted therapy for 4 months, but reported afterwards due to rapid progression. A core-biopsy revealed no presence of usual in-filtrating duct carcinoma, but unequivocal choriocarcinoma-tous differentiation with mononuclear cytotrophoblast-like cells with hyperchromatic nuclei and multinucleated syncy-tiotrophoblast-like giant cells (fig. 1) and strong cytoplasmatic immunoreactivity for β-HCG (fig. 2). Pathologist suggested either a rare variant of invasive breast carcinoma with a cho-riocarcinomatous pattern or metastatic choriocarcinoma to the breast. Metastatic progression was seen; pregnancy, as well as primary choriocarcinoma were excluded; total β-HCG was 80,000 mU/ml. The patient received cisplatin plus etoposide with moderate clinical improvement and rapid decrease of β-HCG level. Invasive carcinoma of the breast with a choriocarcinomatous pattern is an extremely rare subtype of breast cancer listed in the WHO classification, with only few cases reported [1]. Systemic treatment was adjusted to the updated histopathological diagnosis. No optimal chemo-therapy regimen is defined so far, and prognosis is unclear in advanced cases [3].References1. WHO Classification of Tumours, Editorial Board. Breast Tumours, 5th edition. International Agency for Research on Cancer, Lyon 2019.2. Jun SY, Yoon N, An S, et al. Clinicopathologic and Molecular Charac-teristics of and Diagnostic Dilemmas in Invasive Breast Carcinoma with Choriocarcinomatous Pattern apropos a New Case: A Literature Review with New Findings. Pathobiology. 2022; 89(6): 359–369, doi: 10.1159/000522621.Figure 1. Core biopsy of breast carcinoma with a choriocarcinomatous pattern – both components of choriocarcinoma (cytotrophoblast-like and syncytiotrophoblast-like cells) are seen, staining H&E, x100 magnificationFigure 2. Core biopsy of breast carcinoma with choriocarcinomatous pattern – strong immunoreactivity for β-HCG in neoplasmatic cells, β-HCG immunostaining, x200 magnificationBiuletyn Polskiego Towarzystwa Onkologicznego NOWOTWORY2023, tom 8, nr 3, 239© Polskie Towarzystwo OnkologiczneISSN: 2543–5248, e-ISSN: 2543–8077www.nowotwory.edu.pl

Breast invasive carcinoma with a choriocarcinomatous pattern

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Breast invasive carcinoma with a choriocarcinomatous pattern

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