Cystic Hypersecretoric Carcinoma of Breast: A Case Report

Introduction: Cystic hypersecretory carcinoma is a very rare subtype variant of breast cancer, it is one of special variants of ductal carcinoma. Having different pathologies, cystic hypersecretory carcinoma may be in form of a benign or malignant lesion. The average incidence for this breast cancer is 56 years old and all in females by age and gender respectively. At December 2018, this case is reported only 19 cases so far. Therefore, the rare occurrence of this type of malignancy makes it valuable for case reports. Case description: A sliced specimen of 4, 5x3x2 cm of excision biopsy tissue is sent to our anatomical pathology department to be analyzed. Results: Specimen shows multiple cystic lesions with diameters of 0, 5 ? 1 cm. Some part contains colloid - gelatinous substance, and other part contain blood clots. Cystic spaces lined with atypical epithelial cells with dominant micropapillary pattern and complex papillary branching frond as others. Constituent epithelial cell is composed as column with crowding and overlapping, pleomorphic - hyperchromatic to vesicular oval nuclei with prominent nucleoli. Part of nuclei is visible hobnail like appearance. Particular microscopic focuses of invaded areas on conventional HE staining shows desmoplastic response and lymphocyte inflammation infiltrates with moderate to high density with hemosiderin pigment surroundings. These area shows solid islands with centers resembling cystic area. Part of nuclei cells at this area shows angulated grooves and ground - glass appearance. Mitotic is founded 13 - 16/ 10 Hpf. limfovaskuler invasion (LVI) is negative. Conclusion: Pathological specimen shows invasive cystic hypersecretory carcinoma marked by cystic secretory activity of thyroid colloid - like substance, also micropapillary and pseudostratified - arranged cyst with focus of invasion.