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Correspondence
Microinvasive neuroendocrine carcinoma arising from a central papilloma of the breast
  1. Tomonori Kawasaki1,
  2. Masaru Suda2,
  3. Tetsuo Kondo1,
  4. Tadao Nakazawa1,
  5. Kunio Mochizuki1,
  6. Tetsu Yamane1,
  7. Yoshitomo Ito2,
  8. Hiroko Tsunoda3,
  9. Ryohei Katoh1
  1. 1Department of Pathology, University of Yamanashi, Yamanashi, Japan
  2. 2Department of Surgery, Juntendo University Urayasu Hospital, Chiba, Japan
  3. 3Department of Radiology, St. Luke's International Hospital, Tokyo, Japan
  1. Correspondence to Dr Tomonori Kawasaki, Department of Pathology, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi 409-3898, Japan; tomonori{at}yamanashi.ac.jp

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Breast central papilloma is a benign papillary neoplasm usually arising in the subareolar region.1 Cancerous change in a central papilloma is exceptionally rare, and, to our knowledge, there are only a few reports describing this unique condition.2–4 In the WHO Classification of tumours of the breast published in 2003, neuroendocrine carcinoma (NEC) is classified as a special tumour entity representing only about 2–5% of invasive breast carcinomas.5 Herein, we describe the first case of an NEC arising from a central papilloma of the breast.

The patient was a premenopausal Japanese woman, 43 years of age, with a clinical symptom of bloody nipple discharge from the left breast. Ultrasonography revealed a well-defined, localised solid mass in a dilated large duct immediately beneath her left nipple, suggesting an intraductal papilloma (figure 1).

Figure 1

Ultrasonographic finding. A sharply elevated hypoechoic homogeneous mass in the dilated duct beneath the left nipple.

On the cut surface of the lumpectomy specimen from the left breast, a circumscribed grey-whitish tumour was found in a prominently dilated lactiferous duct. Histopathologically, this intracystic tumour was supported by arborised and/or intricate fibrovascular cores lined with myoepithelial cells within a proliferation of two different types of epithelial cells: benign ductal cells and bland-appearing carcinoma cells (figure 2A,B). Benign ductal cells closely lining the myoepithelial cells were cuboidal to columnar in shape with a relatively high nuclear/cytoplasmic ratio and somewhat densely stained nuclei (figure 2B). By contrast, …

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