Abstract
This case describes an infiltrating breast tumour with thyroid transcription factor-1 (TTF-1) positive staining and ductal differentiation in a 72-year-old woman. The presence of ductal carcinoma in situ with positive TTF-1 is a strong indication that this is a primary tumour and not a metastasis from lung.On PET scan and CT follow up there were no other tumours found in this patient. We are not aware of any previously reported TTF-1 positive primary breast carcinoma with ductal differentiation.
Highlights
transcription factor-1 (TTF-1) is a tissue-specific transcription factor expressed in epithelial cells of the lung and the thyroid, including Ccells as well as certain areas of the brain
TTF-1 is expressed in approximately 72% of pulmonary adenocarcinomas[1], and may be a valuable marker for identifying the lung as the site of origin of a metastatic adenocarcinoma
In the case we report, we found no areas typical for small cell carcinoma growth, some areas with trabecular growth gave a partial neuroendocrine impression
Summary
TTF-1 is a tissue-specific transcription factor expressed in epithelial cells of the lung and the thyroid, including Ccells as well as certain areas of the brain. Case Presentation A 72-year-old gravida 1/para 1 woman presented with a palpable mass in the left breast. Her sister died of breast cancer some years earlier. Mammography from upper inner quadrant of the left breast showed a dense, relatively well defined, oval shaped mass lesion with a microlobulated margin measuring 51 × 33 × 35 mm with coarse calcifications centrally in the mass and in addition finer micro calcifications antero lateral to the main tumour, malig-. Ultrasound left breast showed an irregular solid malignant appearing tumour, corresponding to the mammographic lesion, measuring approximately 38 mm maximal diameter. As no other origin for the tumour was found, the patient was treated with left mastectomy and sentinel lymph node mapping. The patient had an uncomplicated recovery and was discharged the day following the operation
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