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Rolim I, Rafael M, Robson A, Costa Rosa J. Pigmented Epidermotropic Breast Carcinoma: A Diagnostic Pitfall Mimicking Melanoma A Case Report and Literature Review. Int J Surg Pathol 2024; 32:386-393. [PMID: 37291852 DOI: 10.1177/10668969231177702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
We report the clinical and pathologic features of a patient with breast carcinoma, who developed clinically visible pigmented skin lesions during the course of the disease. The combination of clinical pigmentation, histological pagetoid epidermal spread, and considerable melanin pigment within tumour cells lead to a misdiagnosis of melanoma. This case provides a striking example of the ability of epidermotropic breast carcinoma to mimic melanoma. A literature review is also reported.
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Affiliation(s)
- Ines Rolim
- Anatomic Pathology, Fundação Champalimaud, Lisboa, Portugal
- Pathology Department, Instituto Portugues de Oncologia de Lisboa Francisco Gentil EPE, Lisboa, Portugal
| | - Margarida Rafael
- Dermatology Department, Instituto Portugues de Oncologia de Lisboa Francisco Gentil EPE, Lisboa, Portugal
| | - Alistair Robson
- Pathology Department, Instituto Portugues de Oncologia de Lisboa Francisco Gentil EPE, Lisboa, Portugal
- Source LDPath, London, UK
| | - Joaninha Costa Rosa
- Pathology Department, Instituto Portugues de Oncologia de Lisboa Francisco Gentil EPE, Lisboa, Portugal
- Pathology, Nova Medical School/Faculdade de Ciências Médicas da Universidade Nova de Lisboa, Lisboa, Portugal
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Khazaeli M, Maruthi VK, See S, Ondracek T, Gerami P. Melanocyte colonization and pigmentation of breast carcinoma: A case report. J Cutan Pathol 2024; 51:280-283. [PMID: 38114301 DOI: 10.1111/cup.14564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 11/13/2023] [Accepted: 11/19/2023] [Indexed: 12/21/2023]
Abstract
Pigmented mammary Paget disease is a rare variant of mammary Paget disease that is often clinically misdiagnosed as a melanocytic lesion of the skin or nipple-areolar complex. Careful morphological assessment, along with the performance of adequate immunohistochemical stains, will help in achieving the right diagnosis and avoiding misdiagnosis of the entity as malignant melanoma. We report a rare case of pigmented mammary Paget disease with concomitant colonization of the underlying invasive ductal carcinoma by melanocytes mimicking melanoma.
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Affiliation(s)
- Mahyar Khazaeli
- Department of Pathology, University at Buffalo, Buffalo, New York, USA
| | | | - Sharlene See
- Department of Dermatology, Section of Dermatopathology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Theodore Ondracek
- Department of Pathology, University at Buffalo, Buffalo, New York, USA
| | - Pedram Gerami
- Department of Dermatology, Section of Dermatopathology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
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Santoro A, Angelico G, Fiorentino V, Zhang Q, Spadola S, Carlino A, Sanchez AM, Franceschini G, Zannoni GF, Mulè A. Melanocyte Colonization and Pigmentation of Breast Carcinoma: Description of Two Pathological Cases and Review of Literature. Diagnostics (Basel) 2021; 11:diagnostics11040709. [PMID: 33921072 PMCID: PMC8071371 DOI: 10.3390/diagnostics11040709] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/09/2021] [Accepted: 04/13/2021] [Indexed: 11/16/2022] Open
Abstract
Colonization of breast carcinoma by non-neoplastic melanocytes of epidermal origin was first described by Azzopardi and Eusebi in 1977. We herein report two cases on the exceptional clinical and pathological features of this phenomenon in a 66-year-old and a 51-year-old patients. The pathogenesis is not fully understood, but a disrupted basement membrane and the role of tumoral growth factors are considered essential.
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Affiliation(s)
- Angela Santoro
- Unità di Ginecopatologia e Patologia Mammaria, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy; (A.S.); (G.A.); (V.F.); (Q.Z.); (S.S.); (A.C.); (A.M.)
| | - Giuseppe Angelico
- Unità di Ginecopatologia e Patologia Mammaria, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy; (A.S.); (G.A.); (V.F.); (Q.Z.); (S.S.); (A.C.); (A.M.)
| | - Vincenzo Fiorentino
- Unità di Ginecopatologia e Patologia Mammaria, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy; (A.S.); (G.A.); (V.F.); (Q.Z.); (S.S.); (A.C.); (A.M.)
| | - Qianqian Zhang
- Unità di Ginecopatologia e Patologia Mammaria, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy; (A.S.); (G.A.); (V.F.); (Q.Z.); (S.S.); (A.C.); (A.M.)
| | - Saveria Spadola
- Unità di Ginecopatologia e Patologia Mammaria, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy; (A.S.); (G.A.); (V.F.); (Q.Z.); (S.S.); (A.C.); (A.M.)
| | - Angela Carlino
- Unità di Ginecopatologia e Patologia Mammaria, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy; (A.S.); (G.A.); (V.F.); (Q.Z.); (S.S.); (A.C.); (A.M.)
| | - Alejandro Martin Sanchez
- Department of Woman and Child Health and Public Health, Division of Breast Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli, 8, 00168 Rome, Italy; (A.M.S.); (G.F.)
| | - Gianluca Franceschini
- Department of Woman and Child Health and Public Health, Division of Breast Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli, 8, 00168 Rome, Italy; (A.M.S.); (G.F.)
| | - Gian Franco Zannoni
- Unità di Ginecopatologia e Patologia Mammaria, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy; (A.S.); (G.A.); (V.F.); (Q.Z.); (S.S.); (A.C.); (A.M.)
- Istituto di Anatomia Patologica, Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168 Roma, Italy
- Correspondence:
| | - Antonino Mulè
- Unità di Ginecopatologia e Patologia Mammaria, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy; (A.S.); (G.A.); (V.F.); (Q.Z.); (S.S.); (A.C.); (A.M.)
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Subhadarshani S, Yusuf N, Elmets CA. IL-23 and the Tumor Microenvironment. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1290:89-98. [PMID: 33559857 DOI: 10.1007/978-3-030-55617-4_6] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
The tumor microenvironment (TME), which assists in the development, progression, and metastasis of malignant cells, is instrumental in virtually every step of tumor development. While a healthy TME can protect against malignancy, in an unhealthy state, it can result in aberrant cellular behavior and augment tumor progression. Cytokines are one component of the TME, therefore, understanding the composition of the cytokine milieu in the tumor microenvironment is critical to understand the biology of malignant transformation. One cytokine, interleukin (IL)-23, has received particular scrutiny in cancer research because of its ability to manipulate host immune responses, its role in modulating the cells in TME, and its capacity to directly affect a variety of premalignant and malignant tumors. IL-23 belongs to the IL-12 cytokine family, which is produced by activated dendritic cells (DC) and macrophages. IL-23 acts by binding to its receptor consisting of two distinct subunits, IL-12Rβ1 and IL-23R. This, in turn, leads to janus kinase (JAK) activation and signal transducer and activator of transcription (STAT) 3/4 phosphorylation. There have been contradictory reports of pro- and antitumor effects of IL-23, which likely depend on the genetic background, the type of tumor, the causative agent, and the critical balance of STAT3 signaling in both the tumor itself and the TME. Clinical trials of IL-12/23 inhibitors that are used to treat patients with psoriasis, have been scrutinized for reports of malignancy, the most common being nonmelanoma skin cancers (NMSCs). Continued investigation into the relationship of IL-23 and its downstream pathways holds promise in identifying novel targets for the management of cancer and other diseases.
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Affiliation(s)
| | | | - Craig A Elmets
- Department of Dermatology, O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, University Boulevard, Birmingham, AL, USA.
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