A Case of C-region Medullary Breast Carcinoma with Rotter's Node Involvement with Similar Appearance to Axillary Lymph Node Metastasis

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  • YOSHINAKA Heiji
    Department of Breast Surgery, Kagoshima City Hospital
  • NAGATA Ayako
    Department of Breast Surgery, Kagoshima City Hospital
  • MIZOGUCHI Tadao
    Department of Breast Surgery, Kagoshima City Hospital Department of Breast Surgery, Kagoshima University
  • NOMOTO Yuki
    Department of Breast Surgery, Kagoshima City Hospital Department of Breast Surgery, Kagoshima University
  • SUEYOSHI Kazunobu
    Department of Pathology, Kagoshima City Hospital
  • KIJIMA Yuko
    Department of Breast Surgery, Kagoshima University

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Other Title
  • 腋窩リンパ節転移と鑑別を要しRotterのみに転移したC領域乳腺髄様癌の1例
  • 症例 腋窩リンパ節転移と鑑別を要しRotterのみに転移したC領域乳腺髄様癌の1例
  • ショウレイ エキカリンパセツ テンイ ト カンベツ オ ヨウシ Rotter ノミ ニ テンイ シタ C リョウイキ ニュウセンズイヨウガン ノ 1レイ

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Medullary carcinoma is a rare histological breast tumor type, accounting for 1-2% of all breast cancers. The tumor is generally well demarcated and its margin is relatively clear. Histologically, large non-polarized and immature cancer cells with clear nucleoli are common and proliferative, resembling the medulla. The tumors are usually negative for ER, PgR, and HER2 (triple negative). The intraductal component is equivocal and the interstitial lymphocyte permeation is extremely prominent. We experienced a case of medullary carcinoma located in the axillary region, so that it was difficult to differentiate from axillary lymph node metastasis.<BR>A 63-year-old postmenopausal woman was admitted to our hospital with a right axillary mass. Imaging examinations revealed a tumor 3 cm in diameter in the right axillary adipose tissue and interpectoral lymph node swelling 1.4 cm in diameter. Fine needle aspiration cytology and core needle biopsy suggested metastatic carcinoma from an unknown primary tumor. She underwent en-bloc resection including the tumor, axillary to the Rotter's lymph nodes, and the skin and mammary tissue of the outer/upper quadrant. The final histopathological diagnosis was primary medullary breast carcinoma (pT2N1aM0 ; Stage IIB) arising from the marginal mammary gland of the outer/upper quadrant.

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