J Korean Surg Soc.  2010 Jun;78(6):419-422. 10.4174/jkss.2010.78.6.419.

Intracystic Papillary Carcinoma in the Male Breast

• Kim WW
• Hur SM
• Kim SH
• Lee SK
• Kim S
• Cho EY
• Choe JH
• Lee JE
• Kim JH
• Kim JS
• Nam SJ
• Yang JH

• KMID: 2211974
• DOI: http://doi.org/10.4174/jkss.2010.78.6.419

Abstract

Intracystic papillary carcinoma (IPC) is an extremely rare disease in the male breast with a few case reports. We present a case of a 61-year-old male who had IPC and review regarding diagnosis, characteristics and treatment. He had a chief complaint of a subareolar mass. It was diagnosed as a benign cystic intraductal papilloma by fine needle aspiration outside hospital. His radiologic studies including mammography and ultrasonography showed a suspicious malignant mass categorized as a BIRADS 4A in the right subareolar area. Therefore, the patient underwent wide excision without sentinel lymph node biopsy. The final pathologic results revealed a 1.6 cm sized intraductal papillary carcinoma of low nuclear grade with clear resection margin. He has taken tamoxifen and received adjuvant radiation therapy.

Keyword

Intracystic papillary carcinoma; Male breast cancer

MeSH Terms

Biopsy, Fine-Needle
Breast
Breast Neoplasms, Male
Carcinoma, Papillary
Humans
Male
Mammography
Middle Aged
Nitriles
Papilloma, Intraductal
Pyrethrins
Rare Diseases
Sentinel Lymph Node Biopsy
Tamoxifen
Nitriles
Pyrethrins
Tamoxifen

Figure

• 

  Fig. 1 Mammography demonstrated about 1.8 cm sized suspicious malignant mass in right subareolar area with BIRADS 4A category (low suspicious malignancy) and recommended pathologic confirmation.

• 

  Fig. 2 Ultrasonography demonstrated about 1.6 cm septated cystic mass revealed intraductal papilloma by outside FNA in right subareolar area with BIRADS 4A category.

• 

  Fig. 3 Gross specimen showed cystic mass containing clear, brownish fluid. The cyst has well encapsulated fibrous wall and tiny papillary mural nodules.

• 

  Fig. 4 Photomicrograph reveals papillary carcinoma within an apparent cystically dilated duct (H&E stain, ×40).

Reference

1. Tan PH, Sng IT. Male breast cancer: a retrospective study with immunohistochemical analysis of hormone receptor expression. Pathology. 1997. 29:2–6.

2. Romics L Jr, O'Brien ME, Relihan N, O'Connell F, Redmond HP. Intracystic papillary carcinoma in a male as a rare presentation of breast cancer: a case report and literature review. J Med Case Reports. 2009. 3:13.

3. Solorzano CC, Middleton LP, Hunt KK, Mirza N, Meric F, Kuerer HM, et al. Treatment and outcome of patients with intracystic papillary carcinoma of the breast. Am J Surg. 2002. 184:364–368.

4. Fentiman IS, Fourquet A, Hortobagyi GN. Male breast cancer. Lancet. 2006. 367:595–604.

5. Dragoumis DM, Tsiftsoglou AP. Intracystic papillary carcinoma associated with ductal carcinoma in situ in a male breast. J Postgrad Med. 2008. 54:39–40.

6. Sinha S, Hughes RG, Ryley NG. Papillary carcinoma in a male breast cyst: a diagnostic challenge. Ann R Coll Surg Engl. 2006. 88:W3–W5.

7. Kinoshita T, Fukutomi T, Iwamoto E, Takasugi M, Akashi-Tanaka S, Hasegawa T. Intracystic papillary carcinoma of the breast in a male patient diagnosed by core needle biopsy: a case report. Breast. 2005. 14:322–324.

8. Carter D, Orr SL, Merino MJ. Intracystic papillary carcinoma of the breast. After mastectomy, radiotherapy or excisional biopsy alone. Cancer. 1983. 52:14–19.

9. Grabowski J, Salzstein SL, Sadler GR, Blair S. Intracystic papillary carcinoma: a review of 917 cases. Cancer. 2008. 113:916–920.

10. Lefkowitz M, Lefkowitz W, Wargotz ES. Intraductal (intracystic) papillary carcinoma of the breast and its variants: a clinicopathological study of 77 cases. Hum Pathol. 1994. 25:802–809.