Long-Standing Scirrhous Breast Carcinoma en Cuirasse

Abstract

BACKGROUND: The stromal reaction may be one of the key factors in the development of breast carcinomas. CASE REPORT: We report the case of an 80-year-old female patient who ignored a very slow growing, extensive scirrhous breast carcinoma for almost 20 years duration. RESULTS: Histopathology analysis revealed a Scarff Bloom Richardson (SBR)3-grade, estrogen receptor (ER)-positive (80%), progesterone receptor (PR)-positive (10%), HER2/neu-negative, lobular-invasive, scirrhous breast carcinoma with large cells. CONCLUSION: A strong peritumoral fibrous stromal reaction may explain the longstanding evolution of the tumor without any distant metastases.

Fig. 1

Scirrhous breast cancer called ‘cancer en cuirasse’. An 80-yearold woman presenting with global breast retraction and biopsy-proven malignant permeative nodules on the overlying skin (arrows).

Fig. 2

Histological section of the breast specimen (hematoxylin-eosin stain, × 200). The histological section shows clusters of tumoral cells surrounded by dense extensive fibrous stroma rich in collagen fibers (arrows) and the presence of few fibroblasts.

Fig. 3

3-Dimensional multidetector CT reformation of the right breast. Volume-rendering, CT scan reformation clearly shows the strong fibrous skin/nipple retraction and enlarged veins at the periphery. Despite the invasion of the whole mammary gland and the areolar plaque involvement, neither internal thoracic adenopathy nor distant metastases were depicted on the total-body CT scan, 20 years after initial clinical presentation.