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Case Report

An unusual case of encapsulated papillary carcinoma of breast

Kriti Chauhan, Monika Garg
Department of Pathology, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala, Haryana 133203, India.
Correspondence to: Dr. Kriti Chauhan, Department of Pathology, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana,
Ambala, Haryana 133203, India. E-mail: kritichauhan25@gmail.com

Dr. Kriti Chauhan works as an Assistant Professor in Mmimsr, Mullana, Ambala, Haryana. She has done her post
graduation in pathology from Gujarat Cancer and Research Institute, Ahmedabad. She has an interest and special
inclination towards oncopathology.

A B S T R AC T
Intracystic (encapsulated) papillary carcinoma of breast is a rare variant of breast cancer. It is usually a low-grade tumor showing
estrogen, progesterone positivity. The authors report an unusual case of intracystic papillary carcinoma showing high nuclear
grade, brisk mitosis, and necrosis with triple negativity for estrogen, progesterone, and Her-2/neu receptors, as well as negative
axillary lymph nodes. Such cases need to be reported to increase awareness so that they will be managed conservatively, avoiding
any overtreatment despite being high grade and triple negative.

Key words: Intracystic papillary carcinoma; high grade; triple negative

INTRODUCTION CASE REPORT

Intracystic (encapsulated) papillary cancer (IPC) is a A 60-year-old female presented with a complaint of
rare entity of breast cancer accounting for approximately progressively increasing swelling in the right breast since
1 to 2% of all breast tumors and usually presenting one year. The swelling was not associated with any pain
in postmenopausal women. Histologically, it is or discharge. On physical examination, a 2 cm × 2 cm
[1]
characterised by an expansile papillary lesion which relatively firm lump was palpable in the upper outer
is surrounded by a thick fibrotic wall and an absent quadrant. Mammography revealed a lobulated, well-
defined nodular mass. Ultrasonography showed a well-
myoepithelial cell (MEC) lining. These lesions are known delineated, heterogeneous, hypoechoic solid lesion with
to have an excellent prognosis with only sufficient local no axillary lymphadenopathy. Fine-needle aspiration
therapy. They tend to have low-grade nuclei and low cytology was performed, which showed sheets and
[2]
mitotic activity, and to be estrogen (ER) and progesterone occasional papillary clusters of ductal cells revealing
(PR) receptors positive and Her-2 neu negative. To date, extensive pleomorphism, vesicular nuclei, and prominent
[3]
there are only two reported cases of IPC which are triple nucleoli [Figure 1]. Based on these findings, a diagnosis
negative in the literature. [2,4] Our case is unusual in being of high-grade ductal carcinoma was offered. Despite being
a noninvasive encapsulated grade III papillary carcinoma a T2N0 tumor, a modified radical mastectomy (MRM)
with negative nodes and triple-negative immunostaining.
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How to cite this article: Chauhan K, Garg M. An unusual case of
encapsulated papillary carcinoma of breast. J Cancer Metastasis Treat
DOI: 2016;2:224-7.
10.20517/2394-4722.2015.63
Received: 13-08-2015; Accepted: 17-03-2016.

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