Image of the Month (2011-1)
Salivary gland-like carcinoma - Adenoid cystic carcinoma variant
Clinical cancer in a 45 year old female - macroscopically approx 25mm - low power view (x4) of core biopsy
Detail - from above. 'Mouse over' for further detail or more infiltrative area - top right hand corner of low power view above
Main body of tumour showing focal intermediate to strong staining with ER and negative staining with PGR.
Note: classical adenoid cystics of the breast are ER and PGR negative.
Main body of tumour showing dual cell population with CK7 and P63 immunostains ('Mouse over')
Detail of more infiltrative area showin two populations of cells (CK14 positive) and 'Mouse-over', CK7 positive.
This case raises three important points:
- If morphology suggests a special type of carcinoma it is worth pursuing further (with immuno if appropriate) because there may be prognostic implications.
- Because this represents a variant form of adenoid cystic carcinoma (designated salivary gland-like carcinoma on this occasion) a more guarded prognosis should be given.
- In view of the ER result in this case there is an argument for endocrine therapy - in classical adenoid cystics endocrine therapy is not normally offered because the tumours are ER negaive.