Papillary carcinoma of the breast in a male patient with a treated prostatic carcinoma diagnosed by fine-needle aspiration biopsy: a case report and review of the literature

Abstract

Papillary carcinoma of the male breast is very rare. In this case report, we describe the cytologic, histologic, immunohistochemical, and radiological findings of a papillary carcinoma of male breast. A 67-yr-old man, who had a previous history of prostatic adenocarcinoma, presented with a retroareolar painless mass. There was no known history of breast cancer in his family. A fine-needle aspiration biopsy (FNAB) was performed. Cytological examination revealed a cellular aspirate with three-dimensional papillary clusters. A diagnosis of papillary lesion favoring papillary carcinoma was rendered. Immunohistochemical staining of the cell-block of the FNAB revealed the presence of mammaglobin, and the absence of prostatic specific antigen. The patient underwent lumpectomy, which showed a moderately differentiated infiltrating papillary carcinoma with adjacent areas of ductal carcinoma in situ. FNAB is a useful technique in identifying male breast carcinoma. In conjunction with ancillary studies, this procedure can effectively differentiate between a primary versus metastatic lesion.

Figs. 1–11

Fig. 1. Mammographic images: bilateral cranio-caudal (CC) compression view. Figs. 2–7. Fine-needle aspiration cytology (FNAC) smear of papillary carcinoma of the breast. Figs. 2 and 3. Papillary carcinoma of the breast, DQ stain, ×200 and ×400, respectively. Fig. 4. Papillary carcinoma of the breast, Papanicolaou stain, ×200. Fig. 5. Cell-block of papillary carcinoma of the breast, hematoxylin–eosin stain, A ×300. Fig. 6. Cell-block of papillary carcinoma of the breast, immunohistochemical stains for calponin, ×200. Fig. 7. Cell-block of papillary carcinoma of the breast, immunohistochemical stains for mammaglobin, ×300. Figs. 8–11. Histologic section of the excisional biopsy of papillary carcinoma of the breast. Figs. 8 and 9. Papillary carcinoma of the breast, hematoxylin–eosin stain, ×100 and 200, respectively. Fig. 10. Papillary carcinoma of the breast, immunohistochemical stains for PSA, ×200. Fig. 11. Papillary Carcinoma of the breast, immunohistochemical stains for mammaglobin, ×300. [Color figure can be viewed in the online issue, which is available at www.interscience.wiley.com]