Transiently regressing intracystic papillary carcinoma mimicking a fluctuating intramammary lymph node

Intracystic papillary carcinoma (ICPC) of the breast is rare. It is categorized as noninfiltrating papillary ductal carcinoma in situ (DCIS). It protrudes and grows into the inner cavity in a papillary form, usually unaccompanied by severe infiltration in the surrounding interstitium. ICPC is often a noninfiltrating carcinoma and differentiating it from benign intracystic papilloma is difficult using preoperative imaging alone. Therefore, deciding on a treatment policy is often difficult. For correct diagnosis, it is vital to perform fine needle aspiration (FNA) or core needle biopsy (CNB) of the intracystic solid part accurately and under ultrasound guidance. However, the rate of accurate diagnosis by FNA cytology is low, and diagnosis by CNB is reported to be more effective than cytology. CNB of the solid part of a cyst for preoperative diagnosis is difficult and has a sensitivity of 60%. There is also a report stating that preoperative diagnosis could not be obtained in 40% of patients with ICPC. Therefore, biopsy by resection should be considered in patients who cannot be diagnosed by either FNA or CNB. However, DCIS had better be preoperatively diagnosed because not only axillary lymph node dissection but also sentinel lymph node biopsy might be omitted. The patient was a 42-year-old woman. She found a tumor mass in the left inner breast 10 weeks before her initial visit to the author's clinic. It was difficult to differentiate between the benignity or malignancy of the tumor from images, but a diagnosis of ICPC was made using preoperative CNB.

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Literature review and case report of bilateral intracystic papillary carcinoma associated with an invasive ductal carcinoma in a male breast

Breast Disease ◽

10.3233/bd-210001 ◽

2021 ◽

pp. 1-9

Author(s):

Fiona Avau ◽

Marie Chintinne ◽

Sarah Baudry ◽

Frédéric Buxant

Keyword(s):

Lymph Node ◽

Sentinel Lymph Node ◽

Sentinel Lymph Node Biopsy ◽

Literature Review ◽

Papillary Carcinoma ◽

Ductal Carcinoma ◽

Conservative Surgery ◽

Lymph Node Biopsy ◽

Node Biopsy ◽

Intracystic Papillary Carcinoma

Intracystic papillary carcinoma (IPC) is a rare tumor with good prognosis that occurs in only 5% to 7.5% of male breast cancer. We report a case of a 46-year-old man who presented a brown nipple discharge a few months ago. He had a bilateral IPC and an invasive ductal carcinoma on the right breast. A double mastectomy was then performed with a bilateral sentinel lymph node biopsy, and he received chemotherapy, radiotherapy, and hormonotherapy. Two years after the diagnosis, the patient recovered and was free of recurrence. Considering the scarcity of this tumor type, we conducted a systematic literature review on the PubMed of all the cases of IPC in men. The clinical presentation, imaging, and treatment of the 43 case reports from the 41 articles selected were described. Furthermore, no clear guidelines for IPC management are available. Conservative surgery should also be preferred, and a sentinel lymph node biopsy should be performed systematically. Moreover, radiotherapy should be proposed in the case of conservative surgery, and hormone therapy could be proposed in the case of invasive IPC or IPC associated with a ductal carcinoma in situ.

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Kikuchi Disease with enlargement of intramammary lymph node

Radiology Case Reports ◽

10.1016/j.radcr.2020.12.012 ◽

2021 ◽

Vol 16 (2) ◽

pp. 389-391

Author(s):

Michael A Simon ◽

Linda Sanders ◽

Dina Morgan ◽

Syed Abbas ◽

Matthew Tortora

Keyword(s):

Lymph Node ◽

Intramammary Lymph Node

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Tall Cell Variant versus Conventional Papillary Thyroid Carcinoma: A Retrospective Analysis in 351 Consecutive Patients

Journal of Clinical Medicine ◽

10.3390/jcm10010070 ◽

2020 ◽

Vol 10 (1) ◽

pp. 70

Author(s):

Alessandro Longheu ◽

Gian Luigi Canu ◽

Federico Cappellacci ◽

Enrico Erdas ◽

Fabio Medas ◽

...

Keyword(s):

Lymph Node ◽

Papillary Thyroid Carcinoma ◽

Thyroid Carcinoma ◽

Papillary Carcinoma ◽

Papillary Thyroid ◽

Tall Cell Variant ◽

Group A ◽

Tall Cell ◽

Cell Variant ◽

Group B

Background: The aim of this retrospective study was to investigate clinical and pathological characteristics of the tall cell variant of papillary thyroid carcinoma compared to conventional variants. Methods: The clinical records of patients who underwent surgical treatment between 2009 and 2015 were analyzed. The patients were divided into two groups: those with a histopathological diagnosis of tall cell papillary carcinoma were included in Group A, and those with a diagnosis of conventional variants in Group B. Results: A total of 35 patients were included in Group A and 316 in Group B. All patients underwent total thyroidectomy. Central compartment and lateral cervical lymph node dissection were performed more frequently in Group A (42.8% vs. 18%, p = 0.001, and 17.1% vs. 6.9%, p = 0.04). Angiolymphatic invasion, parenchymal invasion, extrathyroidal extension, and lymph node metastases were more frequent in Group A, and the data reached statistical significance. Local recurrence was more frequent in Group A (17.1% vs. 6.3%, p = 0.02), with two patients (5.7%) in Group A showing visceral metastases, whereas no patient in Group B developed metastatic cancer (p = 0.009). Conclusions: Tall cell papillary carcinoma is the most frequent aggressive variant of papillary thyroid cancer. Tall cell histology represents an independent poor prognostic factor compared to conventional variants.

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