Metaplastik Meme Karsinomu: Olgu Sunumu

Metaplastik karsinom nadir bir meme kanseri tipi olup tüm invaziv meme kanserlerinin %1’inden daha azını oluşturur. Bu olgu sunumunda, diğer meme kanserlerine göre daha kötü prognozlu ve agresif seyirli olan metaplastik meme karsinomunun ultrasonografi ve doppler ultrasonografi bulgularını sunuyoruz. Sağ memesinde ele gelen kitle şikâyeti ile başvuran 40 yaşında kadın hastanın meme ultrasonografisinde alt iç kadranda 23 x 20 mm boyutunda, yuvarlak şekilli, mikrolobule konturlu, heterojen, hipoekoik solid lezyon ve komşu parankimde ödem izlendi. Kitleye yapılan renkli doppler incelemede; kitle içinde hafif yüksek dirençli (RI 0.62) arteriyel kan akımları saptandı. Lezyon BI-RADS 4 kategori olarak raporlandı ve eksizyonel biopsi önerildi. Biyopsi sonucu metaplastik meme karsinomu olarak geldi. Tümör dokusunda progesteron reseptörü %70 pozitif, c-erb-B2 %30 pozitif bulundu. Meme radyoluğunun, benign sonografik ve mammografik özelliklere sahip lezyonları değerlendirirken bile metaplastik karsinom gibi kötü prognozlu agresif maligniteler olabileceğini göz önünde bulundurması gerekmektedir.
Anahtar Kelimeler:

Metaplastik karsinom, meme, US

Pages 35-37

M etaplastic carcinoma is a rare type of breast cancer and accounts for less than 1% of all invasive breast cancers. In this report, we aimed to present the ultrasonographic and Doppler ultrasonographic findings of metaplastic carcinoma of the breast which is an aggressive type of breast cancer with worse prognosis than classical breast carcinomas.A 40-year-old female patient presented with a palpable mass in her right breast. Breast ultrasound revealed a heterogeneous hypoechoic, round-shaped, microlobulated mass of 23 x 20 mm of dimensions in the lower inner quadrant of the right breast and also edema of the adjacent parenchyma. We found relative high resistive index”of the feeding arteries (RI: 0.62) in doppler examination of the mass. The lesion was reported as BI-RADS 4 category and excisional biopsy was recommended. Histopathological examination revealed metaplastic carcinoma of the breast. Tumour cells were positive for progesterone receptor (70% positive) and c-erb-B2 (30% positive). Metaplastic carcinoma of the breast, which is an aggressive type of breast cancer with worse prognosis than classical breast carcinomas should be included in the differential diagnosis of breast tumors, even in evaluating lesions with benign sonographic and mammographic features.

___

  • 1. Lim KH, Oh DY, Chi EK. Metaplastic breast carcinoma: Clinicopathologic features and prognostic value of triple negativity. JJCO. 2010; 40(2): 112-8.
  • 2. Znati K, Chahbouni S, Hammas N, Bennis S, Abbas F, Harmouch T. Twelve cases of metaplastic carcinoma of the breast: Experience of the university hospital of Fez Morocco. Arch Gynecol Obstet. 2010 Doi: 10.1007/s00404-010-1474-5
  • 3. Velasco M, Santamaria G, Ganau S, Farrus B, Zanon G, Romagosa C. MRI of metaplastic carcinoma of the breast. AJR. 2005; 184: 1274-8.
  • 4. Park HS, Park S, Kim JH, Lee JH, Choi SY, Park B. Clinicopathologic features and outcomes of metaplastic breast carcinoma: Comparison with invasive ductal carcinoma of the breast. Yonsei Med J. 2010; 51(6): 864-9.
  • 5. Yang WT, Hennessy B, Broglio K, Mills C, Sneige N, Davis WG. Imaging differences in metaplastic and invasive ductal carcinomas of the breast. AJR. 2007; 189(6): 1288-93