Encapsulated papillary carcinoma - breast

Case contributed by Gerard Carbo
Diagnosis certain


New-onset palpable mass in the left breast in a patient with known history of gynecomastia.

Patient Data

Age: 60 years
Gender: Male

Oval-shaped and lobulated circumscribed mass located at left retroareolar region.

Notice the slight increase in bilateral retroareolar breast density with dendritic morphology in relation to signs of bilateral gynecomastia. No abnormal lymph nodes where found at visualized levels on mammography. 

Lying eight-shaped hypoechoic circumscribed lesion with peripheral cystic component (cystic mass) and solid components projecting to the cyst lumen. Some septations were found in the solid portion.

Third US image shows the 14G core-needle biopsy procedure performed through the solid component. 

Case Discussion

Histological results revealed a nuclear grade 2 intracystic papillary carcinoma with multiple foci of intraductal carcinoma. These account for approximately 1-2% of all breast cancers. Its survival rate is often better than most breast carcinomas depending on the nuclear grade and the presence or not of an intraductal component. 

The usual US appearance is a cystic mass, with or without septations, with solid papillary masses projecting into the cyst lumen.

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