Case Of Mucinous Carcinoma Research Articles

A case report: mucinous carcinoma of extrahepatic bile ducts with periportal calcification suggestive of lymphatic calcification.

Mucinous carcinoma is a rare subtype of extrahepatic bile duct (EHBD) cancer in which abundant mucin surrounds cancer cell nests. Calcification is often observed in mucus-producing tumors, and we herein report a case of mucinous carcinoma of EHBD with diffuse periportal calcifications. A 92-year-old woman was seen for jaundice. Non-contrast CT showed diffuse semi-linear branching calcifications extending from the hepatoduodenal ligament along the long axis of the intra- and extrahepatic portal veins. A bile duct mass and multiple lymph nodes were hyperintense on T2-weighted MRI images, and periportal abnormal intensity was visible along the intrahepatic portal tract. On contrast-enhanced CT, the mass and enlarged lymph nodes showed a weak enhancing effect. In addition, a lesion with a similar enhancing effect was observed in parallel with periportal calcification, raising suspicion of tumor extension. An endoscopic bile duct biopsy was performed, which resulted in the tumor being diagnosed as a mucinous carcinoma. Considering the imaging findings, it was determined to be a mucinous carcinoma of EHBD origin, with lymphatic vessel infiltration and multiple lymph node metastases. The lymphatic tracts presented lymphangitic carcinomatosis extending from the hepatoduodenal ligament to intrahepatic portal tracts, and the diffuse periportal calcification was presumed to be calcification associated with the mucin component of tumor infiltration.

HIGH DOSE RATE BRACHYTHERAPY IN THE TREATMENT OF OPERATED ENDOMETRIAL CANCERS: ABOUT 60 CASES

Introduction:Endometrial cancer is the third gyneco-mammary cancer in the radiotherapy-brachytherapy department of the RABAT national oncology institute.Brachytherapy has an important place in the therapeutic strategy. The objective of the study:Is to analyze the coverage of target volumes as well as the dose to organs at risk with three-dimensional dosimetric planning and toxicity assessment. Material and methods:This is a retrospective study of 60 cases of operated endometrial cancers treated by high dose rate brachytherapy without external radiotherapy or chemotherapy collected in the radiotherapy department of the National Institute of Oncology RABAT between January 2018 and December 2020. A dosimetric scan without injection was performed at the first session and was used to delineate the clinical anatomic target volume (CTV). We evaluated the D100 of the clinical target volume and the D2 cm3 of the bladder, rectum and small intestine. We also analyzed acute genitourinary and gastrointestinal toxicity. Results:The average age of the patients was 49 years. Endometrioid carcinoma accounted for 98.5%, with one case of mucinous carcinoma. All patients underwent surgery.The brachytherapy protocol used was 3 × 7 Gy (75%) or 4 × 5.5 Gy (17%) in weekly sessions A single patient received a reduced total dose of 19.8 Gy in 3 fractions of 5.5 Gy due to a high rectal dose.The average target volume coverage (D100) was 96.50%.The average D2 cm3 per session received by the bladder, rectum and small intestine were 4.06 Gy, 4.9 Gy and 2.8 Gy, respectively.Regarding genitourinary toxicity, we noted two grade 1 cystitis, one grade 2, two grade 1 mucositis and one grade 2.For gastrointestinal toxicity, no cases of grade greater than 1 were noted.No grade 3 or 4 toxicities were recorded. Conclusion:High dose rate brachytherapy has an important place in the therapeutic strategy for endometrial cancer.The very low toxicity recalls the good tolerance of this treatment whichapplies to the entire population.

A morphological and immunohistochemical study of ductal carcinoma in situ, invasive breast carcinoma of no special type, and mucinous carcinoma of the breast in comparison with solid papillary carcinoma regarding neuroendocrine marker expression.

The exact relationship between solid papillary carcinoma (SPC) and invasive breast carcinoma of no special type (IBC-NST) with neuroendocrine differentiation and SPC and mucinous carcinoma (MC) of the breast remains unclear. To clarify the relationship, we conducted a comparative study of morphological and neuroendocrine features between ductal carcinoma in situ (DCIS, 72 cases) and SPC in situ (35 cases), and IBC-NST (103 cases) and invasive SPC (92 cases). We also conducted the study between MC associated with and without SPC. Synaptophysin, chromogranin A, and INSM1 were employed for the immunohistochemical study. IBC-NST had occasionally a morphological similarity with invasive SPC. While 123 of 127 cases with SPC demonstrated diffuse staining with one or more of the neuroendocrine markers, the only one case of DCIS and none of IBC-NST showed it. Type B was observed in 16 of 18 cases of MC associated with SPC and in 13 of 33 cases of MC without it. All the cases of MC with SPC and 6 of 33 cases without it showed diffuse staining for at least one of the neuroendocrine markers. In conclusion, a careful distinction between invasive SPC and IBC-NST with neuroendocrine differentiation is required. We assume that SPC in situ is a potential candidate for precursor of IBC-NST with neuroendocrine differentiation. MC of the breast is suggested to have two pathogenetic pathways through SPC in situ or non-SPC in situ. SPC in situ is thought to be less common as a precursor of MC than non-SPC in situ.

Immunohistochemical expression of PRAME in 485 cases of epithelial tubo-ovarian tumors.

Preferentially expressed antigen of melanoma (PRAME) is a cancer/testis antigen selectively expressed in somatic tissues and various solid malignant tumors and is associated with poor prognostic outcome. Our research aimed to comprehensively compare its expression in a large cohort of tubo-ovarian epithelial tumors and examine its correlation with our clinico-pathologic data, as well as to assess its potential use in diagnostics and therapy.We examined 485 cases of epithelial tubo-ovarian tumors including 107 clear cell carcinomas (CCC), 52 endometroid carcinomas (EC), 103 high grade serous carcinomas (HGSC), 119 low grade serous carcinomas (LGSC)/micropapillary variant of serous borderline tumors (mSBT), and 104 cases of mucinous carcinomas (MC)/mucinous borderline tumors (MBT). The immunohistochemical analysis was performed using TMAs.The highest levels of expression were seen in EC (60%), HGSC (62%), and CCC (56%), while expression in LGSC/mSBT (4%) and MC/MBT (2%) was rare. The clinico-pathologic correlations and survival analysis showed no prognostic significance.The results of our study showed that PRAME is neither prognostic nor a suitable ancillary marker in the differential diagnosis of tubo-ovarian epithelial tumors. Nevertheless, knowledge about the PRAME expression may be important concerning its potential predictive significance, because targeting PRAME as a potential therapeutic option is currently under investigation.

A Case of Mucinous Carcinoma of the Pancreas with Duodenal Invasion

A Case of Mucinous Carcinoma of the Pancreas with Duodenal Invasion

Mucinous carcinoma originating from uterine adenomyosis: a case report

BackgroundUterine adenomyosis is rarely a precursor of malignant tumors, but the most frequent histological subtype is endometrioid carcinoma. We observed a rare case of mucinous carcinoma originating from uterine adenomyosis.Case presentationA 63-year-old Japanese woman presented to our hospital with lower abdominal pain. She had no atypical genital bleeding. Ultrasound demonstrated thickening of the entire uterine wall, but the endometrium was not thick. Magnetic resonance imaging demonstrated an enlarged uterus with thickening of the entire uterine wall, suggesting adenomyosis. On the basis of the specimen of endocervical curettage, adenocarcinoma originating from the endometrium was suspected. Total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed to confirm the diagnosis. Macroscopically, the resected enlarged uterus had no nodules and exudation of mucin was observed from the cut surface of the thickened myometrium. The surface of the endometrium was smooth. On histological examination, mucinous carcinoma invaded almost the entire myometrium. Adenomyotic lesions were distributed focally in the uterine wall, and transition from adenomyotic glandular epithelium to mucinous carcinoma was detected within several foci. Although adenocarcinoma cells proliferated adjacent to the endometrium, the primary endometrial epithelium was atrophic without atypia. Throughout the myometrium, the mucinous carcinoma cells proliferated and floated in dilated lymph vessels with abundant mucin pools. We diagnosed this case as mucinous carcinoma originating from adenomyosis. Although the patient received 11 courses of intravenous adjuvant chemotherapy, she died of disease 18 months after the first operation.ConclusionAs only one case of mucinous carcinoma originating from adenomyosis has been reported to date, this is the second case report of mucinous carcinoma. Moreover, an abnormal manner of proliferation with marked lymphatic permeation of the tumor cells throughout the myometrium was observed.

Mucinous Carcinoma of Breast: A Histopathological and Immunohistochemical Study

Introduction: Mucinous Carcinoma (MC) is a special type of breast cancer. It comprises 4% (1-7%) of all invasive breast cancer. MC is also called colloid breast cancer characterised by nests of cells floating in lakes of mucin. It is divided into two subtypes Pure Mucinous Carcinoma (PMC) and Mixed Mucinous Carcinoma (MMC). PMC classified into two main types according to its structural and cytological features type A (paucicellular) the classical variant with a large amount of extracellular mucin, and type B (hypercellular) a hypercellular variant with less mucin and often with neuroendocrine differentiation. Hormone receptors, Human Epidermal growth factor Receptor-2 (HER2) and MUC2 status play an important role in prognosis and management. Aim: To study histopathological features of MC breast and Immunohistochemical (IHC) status. Materials and Methods: A retrospective study of patients who presented with breast cancer were studied at Department of Pathology, Karnataka Institute of Medical Sciences, Hubballi, Karnataka, India. The study was analysed in June 2002 and authors included data from January 2021 to June 2022. The data included the age at diagnosis, Tumour (T), Lymph Nodes (N), and Metastases (M) (TNM) stage, presence and number of Lymph Node (LN) metastases, Oestrogen Receptor (ER), Progesterone Receptor (PR), HER2 and MUC2 status. The patients in whom the diagnosis of MC of breast was given on histopathology were only included in the study. Patients of breast cancer of other pathological types were excluded from the detailed study. Descriptive statistics like mean, tables, and charts were used with the help of Microsoft office 2007 to interpret the results. Results: A total of 245 patients reported as invasive breast cancer during 18 months of study period, out of which 12 cases diagnosed as MC were taken in study. Amongst 12 cases, eight cases were PMC and four cases were MMC. The mean age at presentation was 63.37±16.38 years (eight PMC) and 60.0±19.30 years (four MMC). A total of 11 out of 12 cases were females and only one was male case (PMC). Majority of PMC 04 (50.0%) and MMC 03 (75.0%) were observed to be in TNM Stage 2, and four of 12 cases of MC had LN metastasis with no distant metastasis. MC showed higher expression of hormone receptors and lower expression of HER2/neu and MUC2 positivity, which corroborates with other studies and concluded that, MC with such an immunohistochemistry profile was prognostically better. Conclusion: Mucinous Breast Carcinoma (MBC) is a rare type of breast cancer accounting for about 4% of all diagnosed breast cancers. These are associated with a better long-term prognosis than other breast cancers. Hormone receptors and HER2 status play an important role in prognosis and management. MUC2 also plays a major role in mediating the proliferation, apoptosis, metastases of breast cancer cells and determining the use of chemotherapy drugs.

Gross Cystic Disease Fluid Protein-15 (GCDFP-15) Expression Characterizes Breast Mucinous Carcinomas in Older Women.

The predominant histological subtype of breast mucinous carcinoma in older women is type B (hypercellular type), and, in younger women, it is type A (hypocellular type). The characteristics of mucinous carcinomas of the same histological subtype may differ between older and younger women. This study aims to systematically clarify the pathological/immunohistochemical features of mucinous carcinomas. A total of 21 surgical cases of mucinous carcinoma (type A/B: 9/12 cases) in the older group (≥65 years) and 16 cases (type A/B: 14/2 cases) in the younger group (≤55 years) (n = 37) were included. Gross cystic disease fluid protein-15 (GCDFP-15) and eight other markers were used for immunostaining. The GCDFP-15-positive rate in the older group was high regardless of the histological subtype (type A, 77.8%; type B, 91.7%). The GCDFP-15 positivity in the older group was significantly higher than that in the younger group (p < 0.001 for Allred score). Among type A, GCDFP-15 positivity was significantly higher in the older group than in the younger group (p = 0.042 for the Allred score and p = 0.007 for the positivity rate). The present results suggest that GCDFP-15 expression characterizes mucinous carcinomas in older women.

Mucinous Proliferations of the Uterine Corpus: Comprehensive Appraisal of an Evolving Spectrum of Neoplasms.

A variety of endometrial lesions may contain mucinous cells. Herein, the author reviews the literature on the classification and clinicopathologic significance of uterine corpus proliferations with a significant mucinous component, assesses the 2020 World Health Organization classification of such lesions, and presents a diagnostic framework. The key epithelial mucinous lesions include mucinous metaplasia, atypical mucinous glandular proliferation and mucinous carcinoma. Each of these categories are classifiable into "usual" and gastrointestinal subtypes, the latter being indicative of intestinal (presence of goblet cells) and/or gastric-type (abundant, pale eosinophilic or clear cytoplasm and well-defined cell borders) morphology. It has been proposed that at least focal expression of gastrointestinal immunohistochemical markers be required for all gastrointestinal type lesions, and for gastrointestinal type atypical mucinous glandular proliferation and carcinoma, minimality or absence of estrogen receptor expression, and the absence of an endometrioid component. Mucinous carcinomas of the usual type, in which >50% of the tumor is comprised of a mucinous component, are the most common. Morphologic subtypes include mucinous carcinoma with microglandular features and mucinous carcinoma with signet rings (signet ring carcinoma). Endometrioid carcinomas with a less than a 50% mucinous component are classified as endometrioid carcinoma with mucinous differentiation. Several studies have directly compared endometrioid and mucinous carcinomas, the latter presumably of the usual type, with respect to patient outcomes after treatment. All have found no difference in overall and disease free survival between these groups. However, three major studies have found mucinous carcinomas to be associated with a higher risk of lymph node metastases. Nineteen cases of mucinous carcinoma of the gastrointestinal type have been reported, and the limited data on their follow-up after primary treatment suggests that this subtype is more clinically aggressive and should accordingly be classified separately from mucinous carcinomas of the usual type. The morphologic spectrum of mucinous carcinoma of the gastrointestinal type is unclear and continues to evolve. Mucinous change, which may sometimes be extensive, may also be associated with papillary proliferation of the endometrium, adenomyoma of the endocervical type, atypical, and typical adenomyomas. In a curettage or biopsy, intestinal type mucinous epithelium may be indicative of any of the gastrointestinal lesions mentioned above, but may also represent samplings of uterine teratomas, yolk sac tumors, genital and extragenital adenocarcinomas with intestinal differentiation, or low-grade appendiceal mucinous neoplasms that secondarily involve the endometrium.

Comparison of clinical behavior between mucinous ovarian carcinoma with infiltrative and expansile invasion and high-grade serous ovarian carcinoma: a retrospective analysis

BackgroundThe aim of this study was to evaluate the clinicopathological factors and prognosis of mucinous carcinoma (MC) with infiltrative invasion, MC with expansile invasion, and high-grade serous carcinoma (HGSC).MethodsCases of MC and HGSC between 1984 and 2019 were identified. The clinicopathological factors and prognosis of MC with infiltrative invasion or expansile invasion and HGSC were retrospectively compared. Although our present study included cases in our previous studies, we extended observational period when analysis was performed. Accordingly, our study added increased cases and survival analysis was newly conducted.ResultsAfter pathological review, 27 cases of MC with infiltrative invasion, 25 cases of MC with expansile invasion, and 219 cases of HGSC were included. MC had a better prognosis in terms of progression-free survival (PFS, p < 0.01) and overall survival (OS, p < 0.01) than HGSC for all International Federation of Gynecology and Obstetrics (FIGO) stages; however, multivariate analysis did not show statistical differences in PFS and OS. There were no statistically significant differences in PFS and OS for all FIGO stages between MC with infiltrative invasion and HGSC. However, in cases with FIGO stages II to IV, MC with infiltrative invasion had worse PFS (p < 0.01) and OS (p < 0.01) than HGSC. In univariate analysis, MC with infiltrative invasion was a worse prognostic factor for PFS (hazard ratio [HR] 2.83, p < 0.01) and OS (HR 3.83, p < 0.01) than HGSC. Compared with HGSC, MC with expansile invasion had better PFS (p < 0.01) and OS (p < 0.01). Multivariate analysis demonstrated that MC with expansile invasion was a better prognostic factor for PFS (HR 0.17, p < 0.01) and OS (HR 0.18, p = 0.03) than HGSC.ConclusionsCompared to the prognosis of HGSC, that of MC was different according to the invasive pattern and FIGO stage. Therefore, future study may be needed to consider this association.

A Case of Mucinous Carcinoma in the Anal Canal Arising Six Years after Surgery as Primary Perianal Paget&apos;s Disease

A Case of Mucinous Carcinoma in the Anal Canal Arising Six Years after Surgery as Primary Perianal Paget&apos;s Disease

A Case of Intrahepatic Mucinous Cholangiocarcinoma

Background: Mucinous carcinoma of the liver is a rare variant of intrahepatic cholangiocarcinoma. Herein, we report a resected case of mucinous carcinoma of the liver with a literature review. Case presentation: A 78-year-old woman was admitted to our hospital because of a large hepatic tumor, which had been revealed during tests for liver dysfunction. CT examination revealed that the large cystic tumor, 15 cm in a diameter, was located in the left hepatic lobe. Enhanced MRI was unable to visualize any nodules on the cyst wall. PET-CT partially detected FDG accumulation at the tumor margin. Extended left lobectomy was performed under a preoperative diagnosis of hepatobiliary cystadenocarcinoma. The extrahepatic bile duct was preserved because an intraoperative fast frozen section showed that the cut margin of the bile duct was cancer-negative. Pathological examination showed that the tumor cells had proliferated in the form of vesicles, and contained a large amount of mucus in the cytoplasm. Immunostaining demonstrated positivity for CK7 and CK19, and negativity for CK20, Hepatocyte, glypican 3, and CDX2. Finally, the hepatic tumor was diagnosed as intrahepatic mucinous cholangiocarcinoma. Conclusion: This case was an extremely rare variant of intrahepatic cholangiocarcinoma.

EP.TH.515A Case of mucinous adenocarcinoma of the breast in a young male patient presenting with a subcutaneous axillary lump

Abstract Aims Mucinous adenocarcinoma of the breast is rarely encountered clinically, and makes up only 0.01% of Breast cancer (BC) cases and &amp;lt; 1% of male breast cancer (MBC). We describe an extremely rare case of mucinous carcinoma in accessory axillary breast tissue in a male. Case details A 48-year old male presented with a subcutaneous lump in his left axilla. Ultrasound described a 30mm hypoechoic mass and core biopsy confirmed mucinous adenocarcinoma, strongly positive for oestrogen and progesterone receptors, HER2 negative. A solitary enlarged axillary node in was sampled (C2) and mammogram reported a 32mm spiculate mass (M4) on the left. PET scan showed uptake only in the known axillary mass. Management Wide Local Excision and Sentinel Lymph Node Biopsy (SLNB) was completed. Histology showed a 27 mm grade 2 mucinous carcinoma, and the patient completed adjuvant radiotherapy and was commenced on tamoxifen. Conclusions MBC is rare, and accounts for only 1% of all BC. Men tend to be diagnosed at an older age (mean is 67 years) and usually have genetic/hormonal risk factors. Histologically, invasive ductal carcinoma makes up 95% of MBC. In every regard therefore, our case breaks the mold since, he was young, had no genetic/family history and no background of gynaecomastia (present in 6-38%). Literature review suggests that this is only the second case of its kind and from it we can learn to be vigilant for MBC in accessory axillary breast tissue as well as the more typical presentations.

Prognostic similarity between ovarian mucinous carcinoma with expansile invasion and ovarian mucinous borderline tumor: A retrospective analysis.

There is a similarity of histological features and survival between ovarian mucinous carcinoma (MC) with expansile invasion and ovarian mucinous borderline tumor (MBT). The aim of this study was to compare the clinical outcomes of MC with expansile invasion with those of MBT based on the 2020 World Health Organization (WHO) criteria.A pathological review was performed on patients with MC, ovarian MBT, and seromucinous borderline tumors that underwent surgery at our hospital between 1984 and 2019. Clinicopathological features were compared retrospectively between MC with expansile invasion and MBT.Among 83 cases of MC, 85 cases of MBT, and 12 cases of seromucinous borderline tumor, 25 MC cases with expansile invasion and 98 MBT cases were included through review. MC cases with expansile invasion were diagnosed with advanced International Federation of Gynecology and Obstetrics (FIGO) stages more frequently (P = .02) than that of MBT cases. In addition, patients with MC with expansile invasion received adjuvant chemotherapy more often (P < .01) than that of patients with MBT. There were no statistically significant differences in recurrence rate (P = .10) between MC with expansile invasion and MBT. Progression-free survival (PFS) was worse in MC cases with expansile invasion than that in MBT cases (P = .01). However, a multivariate analysis for PFS showed that histological subtype, FIGO stage, and adjuvant chemotherapy were not an independent prognostic factor.The prognostic outcome of MC with expansile invasion might mimic those of MBT. These results showed ovarian borderline tumor treatment could be applied to MC treatment.

Frequency of homologous recombination associated gene mutations in Japanese patients with ovarian cancer

<h3>Objectives:</h3> Homologous recombination deficiency (HRD) is a well-known biomarker of PARP inhibitor sensitivity. The Cancer Genome Atlas (TCGA) has clarified that about 50% of high-grade serous ovarian cancer shows HRD. However, the frequency of HRD in Japanese patients with ovarian cancer remains unclear. The aim of JGOG3025 study (NCT03159572) is to identify the frequency of HR-associated gene mutations in ovarian cancer, especially non-serous histologic types. <h3>Methods:</h3> The JGOG3025 study is a collaborative prospective observational study involving 65 study sites throughout Japan. We recruited 996 patients who were clinically diagnosed with ovarian cancer before surgery from March 2017 to March 2019, and 711 patients were eligible for JGOG3025 criteria. After central pathological review, we used frozen tumor tissues to extract DNA and performed targeted sequencing for 51 HR-associated genes in 711 ovarian cancers (298 high-grade serous, 189 clear cell, 142 endometrioid, 15 mucinous, 4 low-grade serous, and 63 others). <h3>Results:</h3> To focus on pathogenic mutations of HR-associated genes which led to HRD, we used only loss-of-function (LOF) mutations (nonsense, readthrough, and frameshift) to perform subsequent analysis. At least one HR-associated gene was mutated in 105 high-grade serous (35.2%), 21 clear cell (11.1%), 36 endometrioid (25.4%), 1 low-grade serous (25.0%) carcinomas. Although 81.8% of ovarian cancers with <i>BRCA1</i> LOF mutation were diagnosed as high-grade serous type, one case of mucinous carcinoma harbored <i>BRCA1</i> c.1961delA. On the other hand, 71.4% of ovarian cancers harboring <i>BRCA2</i> LOF mutation were high-grade serous type. Mutant allele frequencies of <i>BRCA1</i> and <i>RAD51D</i> were apparently higher than that of other HR-associated genes, suggesting allelic imbalance. <h3>Conclusions:</h3> Our findings demonstrated that mutations in HR-associated genes were detected in not only high-grade serous but also non-serous histologic type ovarian cancers. To clarify the frequency of HRD in Japanese patients with ovarian cancer, we need to assess the pathogenicity of missense mutations and investigate the correlation between HR associated gene mutations and HRD score based on copy number assay.

English

BACKGROUND Fine needle aspiration cytology (FNAC) has become the standard primary diagnostic method in carcinoma breast. It is also a useful tool for surgical treatment and prognosis. The present study is designed to correlate cytological grading using Mouriquand’s grading method with histological grading using modified Bloom-Richardson grading method. METHODS This was an observational study. A total of 45 cases of breast carcinoma, aged 30 to 80 years, underwent FNAC and the smears were graded using Mouriquand’s criteria. All the cases were correlated with Bloom-Richardson grade on histopathology in mastectomy specimens. RESULTS There were a total of 44 cases of infiltrating ductal carcinoma and 1 case of mucinous carcinoma on cytology. Patients’ age ranged from 30 to 80 years with a mean of 53.27 years. In terms of cytology, 15 were (33.3 %) grade I cases, 27 (60 %) grade II and 3 (6.7 %) grade III. In histopathology, 19 (42.2 %) were grade I, 21 (46.7 %) were grade II and 5 (11.1 %) were grade III. Grade I showed a sensitivity of 52.6 % and specificity of 84.6 % with positive predictive value of 71.4 % and negative predictive value of 71 %. Grade II showed a sensitivity of 76.2 % and specificity of 50.0 % with positive predictive value of 57.1 % and negative predictive value of 70.6 %. Grade III showed a sensitivity of 20 % and specificity of 95 % with positive predictive value of 33.3 % and negative predictive value of 90.5 %. Concordance rate between cytology and histology of grade I, grade II and grade III tumours was 73.3 %, 59.25 % and 33.3 % respectively. The absolute concordance rate was 62.2 %. CONCLUSIONS Thus, cytological grading of breast carcinoma correlates well with histopathological grading. In the era of multiple treatment modalities and neoadjuvant therapy, cytological grading can be used as a prognostic factor for better management of patients. KEYWORDS Breast Carcinoma, Mouriquand’s Grading, Bloom-Richardson Grading

Correlation of Ecadherin Expression in Endometrial Carcinoma with Tumour Grade and Stage

INTRODUCTION: Endometrial carcinoma (EC) is among the common malignancy in the female with adverse prognosis in the advanced stage. Prediction of its prognosis is important in stratifying EC patients to achieve optimum treatment and improve clinical outcomes. This study is aimed to evaluate the prognostic significance of E-cadherin expression in patients with EC. The present study also investigated the correlation of E-cadherin expression in EC with its tumour grade and stage. MATERIALS AND METHODS: A total of 70 cases of EC were included in the study within eleven years comprising 56 cases of endometrioid carcinoma, 2 cases of mucinous carcinoma, 10 cases of serous carcinoma and 2 cases of clear cell carcinoma. E-cadherin expression was immunohistochemically analysed and compared with clinicopathological parameters. RESULTS: E-cadherin loss of expression shows significant association with non endometrioid EC (p=0.003), high tumour grade (p&lt;0.001) and tumour with distant metastasis (p=0.028). Tumour grade is the main predictor of down-regulation of Ecadherin expression (Grade 3: aOR 8.400, 95%CI 2.534-27.842). There was no significant association found between E-cadherin expression with myometrial invasion, FIGO stage, lymph node status and lymphovascular invasion. CONCLUSION: E-cadherin loss of expression correlates with poor prognostic factors namely high grade and high stage (metastasis) EC. This may serve as a potential prognostic marker for EC&gt;&lt; 0.001) and tumour with distant metastasis (p=0.028). Tumour grade is the main predictor of down-regulation of E-cadherin expression (Grade 3: aOR 8.400, 95%CI 2.534-27.842). There was no significant association found between E-cadherin expression with myometrial invasion, FIGO stage, lymph node status and lymphovascular invasion.

P090. A case of mucinous adenocarcinoma of the breast in a young male patient presenting with a subcutaneous axillary lump

Introduction: Mucinous adenocarcinoma of the breast is rarely encountered clinically, making up only 0.01% of Breast cancer (BC) cases. We describe an extremely rare male case of mucinous carcinoma in accessory axillary breast tissue.

Mucinous Breast Carcinoma: Clinicopathological Comparison With Invasive Ductal Carcinoma.

IntroductionInvasive ductal carcinoma (IDC) is the most common histological subtype of breast cancer. Conversely, many special types of breast carcinoma were described with varying prognosis and hormone receptor status. Mucinous carcinoma (MC) is a rare special subtype of breast cancer, and only a few studies have evaluated the clinicopathological and hormone receptor profile of this type of breast cancer. Therefore, in this study, we compared the clinicopathological characteristics of MC with IDC in our population.MethodsA retrospective observational study was conducted in the Department of Histopathology, Liaquat National Hospital and Medical College, from January 2013 till December 2020, for eight years. During this period, 38 cases of MC were diagnosed and 1268 cases of IDC were identified. All specimens were grossed according to standard protocols and representative sections were submitted from tumors, resection margins, and lymph nodes. Slides were examined by histopathologists to determine tumor type and grade. Immunohistochemical (IHC) stains were applied to evaluate estrogen receptor (ER), progesterone receptor (PR), Ki67, and human epidermal growth factor receptor 2 (HER2/neu) statuses.ResultsThe mean age of the patients with MC was 56.47±13.90 years, and most of the patients were above 50 years of age. The mean tumor size was 34.89±19.70 mm. Most tumors were grade 1 (68.4%) with a low mean Ki67 index (15.21±14.06%). Axillary metastasis was present in 31.6% of cases and all of them were nodal (N)-stage N1. ER, PR, and HER2/neu positivity were noted in 94.7%, 78.9, and 10.5% cases, respectively. Compared with IDC, a significant association of MC was noted with age, Ki67 index, tumor (T)-stage, N-stage, and tumor grade. MC cases had a higher mean age than IDC cases. Comparative analysis revealed that MC had a lower frequency of axillary metastasis, a lower mean Ki67 index, and a lower tumor grade than IDC. About biomarker status, MC was noted to have a higher frequency of ER and PR expression, and a lower frequency of HER2/neu expression than IDC.ConclusionMC is a rare subtype of breast cancer. However, it is important to recognize this subtype of breast cancer as it is associated with a prognostically better pathological profile, such as lower tumor grade and Ki67 index, lower frequency of axillary metastasis, higher expression of ER and PR, and lower expression of HER2/neu.

A Case of Mucinous Carcinoma of the Appendix Penetrating the Ascending Colon

A Case of Mucinous Carcinoma of the Appendix Penetrating the Ascending Colon