Letters to the Editor Letters to the Editor should be submitted online to www.editorialmanager.com/ amsurg. (See details online under ‘‘Instructions for Authors’’.) They should be no more than 3 double-spaced pages excluding an Abstract and sub-headings with a maximum of four (4) references. If figures are included, they should be limited to two (2). The cost of printing color figures is the responsibility of the author. In general, authors of case reports should use the Letter to the Editor format.
Oncocytic Carcinoma of the Breast: Rare Histology To The Editor: Ninety-five per cent of breast carcinomas originate from epithelial cells. Most common histopathologic types are ductal, lobular, colloidal, papillary, medullary, and tubular. Rare types are micropapillary, metaplastic, adenoid cystic carcinoma, Paget, and inflammatory carcinomas. There are three case reports about oncocytic breast carcinoma in English literature.1 We present a patient with a diagnosis of oncocytic breast carcinoma. A 78-year-old woman was admitted to our clinic with complaint of palpable right breast mass. Only a right lumpectomy was performed and diagnosed as an oncocytoma. Tumor diameter was 3 cm with grade III pathology. Immunohistochemically, tumor was ER(+) (90%), PR (+) (75%), and cerb-B2 negative. Ki-67 proliferation index was 15 per cent. Adjuvant hormonal treatment with letrozole was initiated. Oncocytes were first described by Hamperl in 1931 as a specific subgroup of epithelial cells with acidophilic granules in their cytoplasms. Oncocytes have distinct crystals and wide mitochondrias. Although a majority of oncocytic cells originate from epithelial cell differentiation, it can originate from mesenchymal cells.2 It could be benign or malignant. At this time, there are only three cases in the English literature. Palpable breast mass is the most common clinical presentation. Two of the cases were women and all
were above 70 years of age. Two of the cases had invasive carcinomas, one of them had carcinoma in situ and none of the cases has distant metastasis when reported. There is not enough data about the prognosis of oncocytic carcinoma because of the low number of cases. Disease-free survival after modified radical mastectomy was 7 years in one case.3 Breast and pituitary oncocytomas are more malignant than thyroid and renal oncocytomas. We didn’t consider chemotherapy and radiotherapy in our case because of the patient’s age. More information is needed to understand the biology of this rare type of breast carcinoma. Murat Cinel, M.D. Sercan Aksoy, M.D. Didem S. Dede, M.D. Omer Dizdar, M.D. Kadri Altundag, M.D. Hacettepe University Institute of Oncology Ankara, Turkey REFERENCES
1. Damiani S, Eusebi V, Losi L, et al. Oncocytic carcinoma (malignant oncocytoma) of the breast. Am J Surg Pathol 1998;22: 221–30. 2. Ga˘da˘leanu V, Craciun C. Malignant oncocytoma of the breast. Zentralbl Allg Pathol 1987;133:279–83. 3. Costa MJ, Silverberg SG. Oncocytic carcinoma of the male breast. Arch Pathol Lab Med 1989;113:1396–9.
Address correspondence and reprint requests to Kadri Altundag, M.D., Department of Medical Oncology, Hacettepe University Institute of Oncology, Sihhiye, Ankara 06100, Turkey. E-mail:
[email protected].
E25
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
