case_images: PMC11164308_01
case_images: The results of the mammography examination of the right breast
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case_images: F1
case_images: The mass was defined to have a 45-mm diameter with partially obscured margins in the posterior of the right breast's areola; increased density was observed in the superolateral area of the left breast (Figure 1).
case_images: Ultrasound examination of the right breast
case_images: ijp-19-118-g002.jpg
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case_images: F2
case_images: An ultrasound examination of the breast, performed by an expert radiologist, showed normal fibro-glandular tissue in the right breast with a well-circumscribed heterogenic hypoechoic mass, sized 42x32 mm in the superomedial part of the right areola, connected to the nipple at about 10 mm distance from the skin (Figure 2).
case_images: Immunohistochemical staining of the needle biopsy specimen showing positivity of the tumoral cells for A. CD68 (x400), B. Vimentin (x100), and C. Ki67 index was 50% (x100); but negative for D. CK (x100), E. ER (x400), and F. EMA (x100)
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case_images: F3
case_images: Immunohistochemistry (IHC) on needle biopsy specimens showed positive vimentin and CD68 in the tumoral cells, 50% Ki67 labling index, and negative CK, CAM5/2, EMA, Melan A, HMB45, and ER (Figure 3).
case_images: Macroscopic image of the right breast
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case_images: F4
case_images: The macroscopic study showed the right breast (measuring 23x19x7.2 cm; Figure 4) with two fibro-adipose tissue fragments (total measuring 3.5x2.5x2 cm) that serial sectioning revealed two lymph nodes with a diameter of 0.5 and 2.5 cm.
case_images: Microscopic images with hematoxylin and eosin staining showing atypical spindle and epithelial cells (A and B x100) with osteoclastic-like giant cells, high mitotic rate, and pleomorphism (C and D x400); the arrow indicates mitosis
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case_images: F5
case_images: The microscopic evaluation showed a neoplastic proliferation of atypical spindle and epithelial cells with high mitotic rate, pleomorphism, and osteoclastic-like giant cells with atypical mitosis and necrosis (30%; Figure 5).
case_images: Immunohistochemical staining of the resected specimen showing negativity of t the tumoral cells for A. CK (x100), B. P63 (x100), and C. CD34 (x100)
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case_images: F6
case_images: We also performed IHC on the resected specimen on separate blocks, which showed negative CK, P63, and CD34 (Figure 6; A, B, and C, respectively).