Clinicopathological characterization of tall cell carcinoma with reversed polarity of the breast: A case report and review of the litterature.

Background: Tall cell carcinoma of the breast with reverse polarity (TCCRP) is a recently described rare entity with low potential for malignancy which exhibits morphological features with tall cell variant of papillary thyroid carcinoma. Immunohistochemical and molecular studies help establish the diagnosis.

Methods: We report the case of a 45-year-old woman with no significant medical or surgical history who presented with mastodynia. Physical examination was negative. Screening by bilateral mammography revealed a mass of the right breast which was classified as 4B. The mass was surgically excised. The pathological report concluded to a TCCRP of the breast with free margins. The tumor cells were negative for hormone receptors as well as for the Human Epidermal Growth Factor Receptor-2 (HER2neu). The patient underwent a sentinel lymph node dissection that was negative followed by loco-regional radiotherapy. Chemotherapy and endocrine therapy were not indicated for the patient. After 24 months of follow-up, no signs of loco-regional or distant recurrences have been identified. TCCRP is a rare entity that has been recently introduced in the WHO classification of breast cancer. It is usually a triple negative tumor, negative to TTF1 and thyroglobulin with low proliferation index, and a low potential for malignancy. Wide excision is the keystone of the treatment; however, chemotherapy and radiotherapy are still controversial due to lack of evidence.

Conclusions: TCCRP is a rare entity, which carries an excellent prognosis. A proper diagnosis is essential to conduct the best treatment next to a careful follow-up due to the ambiguous natural history of this rare entity. None.