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EP228 Clear cell carcinoma of the breast. A rare histological variant with a poor prognosis. Case report and literature review
  1. I Sassi1,
  2. I Marghli1,
  3. S Kammoun2,
  4. H Bouaziz1,
  5. A Bouida1,
  6. M Slimen1,
  7. O Adouni2 and
  8. K Rahal1
  1. 1Surgical Oncology Department
  2. 2Pathology Department, Institute Salah Azaiez, Tunis, Tunisia


Introduction/Background Clear cell carcinoma of the breast is a rare histological subtype characterized by carcinoma cells containing an optically clear cytoplasm. It accounts for 1–3% of all breast cancer cases.

Methodology We report on the prognosis of two female patients treated in our institute in 2007 and 2013.

We reviewed publications since 1981 to date, using PubMed and Sciencedirect.

Results A 36 year-old women presented with a mass in the right breast. Examination showed irregular lump in the upper outer quadrant of her right breast, measuring 15*10 mm. No locoregional nodes were palpable. Breast imaging showed a high density nodule of 20 mm with irregular margins classified as BIRADS 4. A Tru-cut needle biopsy was performed. The microscopic examination showed an invasive ductual carcinoma containing clear cytoplasm. Breast-conserving surgery with axillary sentinel lymph node biopsy was initially performed. Surgical margins were positive. A complementary mastectomy was done.The patient was submitted for chemotherapy. Four months after the surgery,examination revealed a permeation nodule. The patient resumed the chemotherapy and radiotherapy. Five months later a CT-scan showed lung and mediastinal node metastases. The patient died of respiratory failure.

A 67 year-old women, presented with a mass in the right breast. Examination revealed a hard and irregular mass of 35 mm in the upper outer quadrant of the right breast. Enlarged lymph nodes were palpable in the right axillary. Breast imaging showed a round, high density mass with partially irregular margins measuring 35 mm classified as BIRADS 5. Breast-conserving surgery with lymph node dissection was performed. The microscopic examination showed a poorly differentiated carcinoma with abundant clear cytoplasm.Two months after surgery, examination showed a permeation nodule. The patient was sent to chemotherapy. After two cycles of chemotherapy, she developed a rhino-orbito-cerebral mucormycosis and died after a month.

Conclusion Clear cell carcinoma of the breast is an aggressive subtype with bad prognosis.

Disclosure Nothing to disclose.

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