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Diagnostics Histology, Oncology

Case of the Month

A 53-year-old lady presented with swelling at the right temporal region of the head. Excisional biopsy was performed.

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What is the diagnosis?

a. Hidradenoma papilliferum
b. Tubular apocrine adenoma
c. Papillary eccrine adenoma
d. Syringocystadenoma papilliferum

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We will reveal the answer next month.

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Submitted by San Yu Maung, Pathologist, Mandalay General Hospital, Mandalay, Myanmar.

B. p63

The images show metaplastic squamous cell carcinoma (SCC), an aggressive variant of metaplastic breast carcinoma (MBC) that demonstrates squamous differentiation. Histologically, metaplastic SCC are frequently cystic and are lined by atypical squamous cells; however, they can also demonstrate solid architecture (1–3). Like other MBC, these tumors are typically positive for p63 and high-molecular-weight cytokeratin. p63 is a highly sensitive and specific marker for MBC (86.7 and 99.4 percent, respectively) (4). In daily practice, a combination of several stains (such as cytokeratin cocktail, p63, or high-molecular-weight cytokeratin) is usually needed for an accurate diagnosis of MBC.

Submitted by Emily R. McMullen, House Officer IV at the University of Michigan, Ann Arbor, Michigan, USA.

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  1. JS Reis-Filho et al., WHO Classification of Tumours of the Breast, 4th edition. International Agency for Research on Cancer: 2012.
  2. N Cha et al., Am J Case Rep, 19, 203 (2018). PMID: 29472521.
  3. ER McMullen et al., Arch Pathol Lab Med, 143, 1492 (2019). PMID: 31765246.
  4. MM Koker, CG Kleer, Am J Surg Pathol, 28, 1506 (2004). PMID: 15489655.
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