Breast Carcinoma withChoriocarcinomatous Features

Abstract

Breast cancer with choriocarcinomatous features is a rare variant of breast malignancy with poor prognosis and poor response to treatment. The tumour cells express high expression of human chorionic gonadotropin in cancer cells such as multinucleated syncytioblast like giant cells. The histogenetic origin of these cells is unknown but the most reliable theory involves a metaplastic process. The frequently found metaplastic changes are squamous, spindle cells, or osseous, chon­droid, or matrix production. Non-gestational choriocarcinomatous differentiation is extremely rare in breast neoplasms. Choriocarcinomatous differentiation has also been described in tumour arising from many organs including lung, rectum, colon, stoamach and urinary bladder. Most of the patient with choriocarcinomatous features presents with high grade disease, that is exhibiting an aggressive clinical course with an overall survival of less than a year. In this case report, the history, physical examination, laboratory findings and pathological findings of breast carcinoma in a 40year old woman are described. The patient underwent lumpectomy of left breast. Microscopically the tumour was reported as Invasive ductal carcinoma with choriocarcinomatous features. Nottingham grade III, ER- Negative, PR- Negative, HER2-neu Negative . Histology of choriocarcinoma in breast is distinctly unusual. Before making a confirmatory diagnosis of breast cancer with choriocarcinomatous features a possibility of metastatic choriocarcinoma to the breast should always be ruled out because of its poor prognosis.