Human epidermal growth factor receptor-2 overexpression and amplification in metastatic and recurrent high grade or type 2 endometrial carcinomas

Background: Urothelial carcinoma is the common carcinoma of urothelium. Its incidence is high in developed countries but itsoccurrence is increasing in developing countries like Pakistan with mortality rate of 3.8/100,000 in males and 1/100,000 in females.HER2 is a member of the human epidermal growth factor receptor (HER/EGFR/ERBB) family.Amplification or over-expression ofthis oncogene has been shown to play an important role in the development and progression urothelial carcinoma.Objective: To evaluate the relationship between HER2/NEU expression and grades of urothelial carcinoma bladderMaterial and Methods: This was a cross-sectional descriptive study for the period of six months from January to June, 2017conducted at Pathology section Rehman Medical Institute Peshawar. After approval from university Ethical board 63 cases wereselected by purposive sampling.The Tissue samples from diagnosed cases of urothelial carcinoma of urinary bladder were included.Cases of urothelial carcinoma from other sites were excluded. Paraffin embedded tissue blocks were cut and sections stained byH&E to evaluate histopathological features and tumor grades. Immunohistochemical expression of HER2 was determinedapplying standard techniques of immunohistochemistry.Results: Out of total 63 cases, 47 were males and 16 were female with a mean age of 60.7 years (range 14-90 years). There were38 High grade, 23 Low grade and 2 cases of PUNLMP. 36 cases were positive for HER2 expression in which 26(72.2%) were Highgrade, 9(25%) of Low grade and 1(2.7%) of PUNLMP. High grade was more common in HER2 positive cases and this relationshipwas significant (p<.05). Among positive 36 cases, 19 cases of +3 score were High grade, 05 in Low grade and 01 in PUNLMP whilescore 2+ was in 07 cases of High grade and 04 were in Low grade. The relationship of HER2 score was not significantly related tograde of tumor (p>.05)Conclusion: HER2 is highly expressed in high grades of urothelial carcinoma bladder and this relationship between HER2expression and tumor grades is statistically significant.Keywords: HER2, Urothelial carcinoma, Grades, Immunohistochemistry

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Carcinoma metaplásico com diferenciação mesenquimal: relato de caso

10.5327/jbg-0368-1416-2020130241 ◽

2020 ◽

Author(s):

Laura Ramos Silva Ferzel ◽

Kiara de Medeiros Braga Cruz Pessanha ◽

Renata Magliano Marins ◽

Meire Cardoso da Mota Bastos ◽

Isabelly dos Santos Belo

Keyword(s):

Epidermal Growth Factor Receptor ◽

Growth Factor ◽

Epidermal Growth Factor ◽

Core Biopsy ◽

Growth Factor Receptor ◽

Electronic Library ◽

Ki 67 ◽

Human Epidermal Growth Factor ◽

Epidermal Growth

Introdução: Equivalendo a menos de 5% de todos os cânceres de mama, o carcinoma metaplásico representa um grupo morfologicamente heterogêneo das neoplasias malignas mamárias, que acomete, em sua maioria, mulheres na pós-menopausa. A principal manifestação clínica é nódulo palpável de crescimento progressivo e rápido. Histologicamente, é caracterizado por combinar componente epitelial e componente escamoso ou sarcomatoide. Manifesta-se tipicamente negativo para receptores hormonais e Human Epidermal growth factor Receptor-type 2 (HER2), independentemente do subtipo histológico. Objetivo: Relatar caso de carcinoma metaplásico que não foi diagnosticado em material de core biopsy. Método: Levantamento de dados clínicos, laboratoriais, exames de imagem e revisão bibliográfica pelas fontes PubMed, Literatura Latino-americana e do Caribe em Ciências da Saúde (LILACS) e Scientific Electronic Library Online (SciELO). Resultados: K.C.M.S.R., 35 anos, com queixa de nódulo palpável de crescimento progressivo em mama esquerda. Ultrassonografia (USG) de mamas: nódulo heterogêneo de contornos irregulares, em quadrante inferior lateral (QIL) da mama esquerda, medindo cerca de 4,5×4,1 cm, BIRADS 4. Laudo histopatológico de core biopsy: carcinoma invasivo SOE (padrão ductal — Organização Mundial da Saúde (OMS) 2012) grau histológico 3. Imuno-histoquímica: receptor de estrogênio e progesterona negativo, HER2 inconclusivo, FISH negativo e Ki 67 90% em mama esquerda. Indicada quimioterapia neoadjuvante, sem resposta e com progressão da lesão para aproximadamente 9 cm. Paciente então foi submetida à mastectomia com biópsia de linfonodo sentinela (BLS). Laudo anatomopatológico de peça cirúrgica constatou carcinoma metaplásico com componente de condrossarcoma. Conclusão: Apesar de triplo negativo, o carcinoma metaplásico não apresenta boa resposta à quimioterapia neoadjuvante. A cirurgia ainda é o principal tratamento em pacientes com tumores operáveis, independentemente do tamanho do tumor. Mais estudos são necessários para avaliação do comportamento biológico e da conduta terapêutica.

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