Exuberant complex metaplastic carcinoma of the breast with SOX2 expression: Cove ring the full spectrum of ductal neoplasia of the breast

Abstract

We report a unusual case of a 45-year-old woman with a massive metaplastic carcinoma of the breast with a complex admixture of components including giant pleomorphic cells, sarcomatoid areas, cysts with undifferentiated stratified epithelium, squamous carcinoma foci, high grade comedo-type ductal carcinoma in situ, high grade invasive carcinoma not otherwise specified (NOS) and foci with osseous differentiation. An extensive immunohistochemical panel showed expression of both epithelial and mesenchymal markers. The self-renewal marker SOX2 was expressed in different cell types, which was interpreted as a sign of the pluripotency what can in turn explain the diversity of histologic lineages present in this tumour.

Resumen

Presentamos el caso de una mujer de 45 años con un carcinoma metaplásico de presentación clínica exuberante, que mostraba una combinación compleja de diversos componentes, incluyendo células gigantes pleomórficas, áreas sarcomatoides, quistes con epitelio escamoso indiferenciado, focos de carcinoma escamoso, carcinoma ductal in situ de tipo comedo, carcinoma infiltrante de tipo usual y focos de diferenciación ósea. El amplio panel inmunohistoquímico mostraba expresión de marcadores tanto epiteliales como mesenquimales. El marcador de autorenovación SOX2 se expresaba en diferentes tipos celulares, lo cual fue interpretado como un signo de pluripotencialidad y podría explicar la diversidad de tipos histológicos presentes en este tumour.