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Case Reports
. 2017 Jul 11;12(1):52.
doi: 10.1186/s13000-017-0641-4.

Pancreatic metastasis from invasive pleomorphic lobular carcinoma of the breast: a rare case report

Xiangjie Sun  1   2 , Ke Zuo  1   2 , Dan Huang  1   2 , Baohua Yu  1   2 , Yufan Cheng  1   2 , Wentao Yang  3   4
Affiliations
Case Reports

Pancreatic metastasis from invasive pleomorphic lobular carcinoma of the breast: a rare case report

Xiangjie Sun et al. Diagn Pathol. .

Abstract

Background: Invasive pleomorphic lobular carcinoma (PLC) is an aggressive subtype of invasive lobular carcinoma of the breast, which has its own histopathological and biological features. The metastatic patterns for PLC are distinct from those of invasive ductal carcinoma. In addition, pancreatic metastasis from PLC is extremely rare.

Case presentation: We report a rare case of a 48-year-old woman presenting with clinical gastrointestinal symptoms and pancreatic metastasis of PLC. The pancreatic tumor was composed of pleomorphic tumor cells arranged in the form of solid sheets and nests and as single files, with frequent mitotic figures, nucleolar prominence, high nuclear to cytoplasmic ratio and loss of cohesion. The malignant cells were positive for p120 (cytoplasmic) and GATA3 and negative for estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2, E-cadherin, gross cystic disease fluid protein 15 and mammaglobin, which indicated a lobular carcinoma phenotype of the breast.

Conclusions: To the best of our knowledge, this is one of the few reported cases in the literature of pancreatic metastasis of invasive lobular carcinoma of the breast, of which the definitive diagnosis was obtained only after surgery. Rare metastasis sites should be considered, particularly, when a patient has a medical history of PLC.

Keywords: GATA3; Metastasis; Pleomorphic lobular carcinoma; Triple-negative breast cancer.

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Conflict of interest statement

Ethics approval and consent to participate

This case study was approved by the Institutional Review Board for ethical committee of Fudan University Shanghai Cancer Center.

Consent for publication

Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.

Competing interests

The authors declare no conflicts of interest.

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Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
a: Contrast-enhanced computed tomography scan of the abdomen showing a low-density mass confined to the neck of pancreas. b: Positron emission tomography/computed tomography scan of the pelvis: a lytic bony lesion in the right caput femoris, with abnormal uptake of fluorodeoxyglucose
Fig. 2
Fig. 2
Photomicrograph of the lesion in pancreas. a: The malignant cells infiltrating the lobules of pancreas (H&E, ×100). b: The tumor cells arranging in the form of solid sheets and single files (H&E, ×100). c: The tumor cells demonstrating a targetoid growth pattern and nerve invasion (H&E, ×200). d: High magnification showing the polygonal cell contours, abundant eosinophilic cytoplasm, high nuclear to cytoplasmic ratio and loss of cohesion (H&E, ×400). e: Diffuse strong cytoplasmic staining for p120 (Envision, ×200). f: Diffuse strong nuclear staining for GATA3 (Envision, ×200)
Fig. 3
Fig. 3
Photomicrograph of the primary breast lesion. a: The malignant tumor cells showing a targetoid growth pattern or arranging in the form of solid sheets and single files (H&E, ×100). b: Abundant and eosinophilic cytoplasm of the cells, with nuclei of increased size and nucleolar prominence (H&E, ×200). c: Negative E-cadherin immunostaining of tumor cells with positive internal control in the residual duct (Envision, ×200). d: Moderate to strong nuclear staining for GATA3 (Envision, ×200)
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