Browsing by Author "Gradil, A."
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- Metaplastic carcinoma of the breast: case series of a single centrePublication . Fialho, M. Pinto; Gonçalves, L.; Ruivo, L.; Gradil, A.; Correia, L.Background & objectives: Metaplastic carcinoma breast cancer (MpBC) is a rare and heterogeneous group of invasive breast carcinomas. Despite some studies and case reports data are currently limited. Our work aims to evaluate the clinicopathological features and the prognosis of MpBC patients. Methods: Retrospective unicentric study of MpBC diagnosed from January 2000 to February 2024. Pathological reports were accessed for specific patterns of MpBC, grouped as monophasic/biphasic tumors and TNM stratified according to WHO Breast Tumours 5th edition and AJCC 8th edition. Time-to-event outcomes were calculated using the Kaplan-Meier method and the log-rank test. Results: We identified 44 patients, 1 male, median age 59 years-old (33-98), 9 metastatic ad-initio. Biphasic-MpBC corresponded to 77%; heterologous-mesenchymal-differentiation was found in 34%, and spindle-cell carcinoma in 6.8%. Ki67 ranged from 20 to 95%. Twenty-seven were triple-negative, eight luminal-B, and six HER2-positive tumors. The median follow-up time was 82.1 months and the median overall survival (mOS) was 32.1 months. Subgroup analysis showed no statistically significant differences between monophasic/biphasic MpBC or histological patterns. Metastatic patients and patients over 60 years had a poorer prognosis (25.1 vs 115.5 months p=0.053; 20.0 months vs mOS have not reached p=0.001, respectively). In luminal-B patients, mOS were not reached (vs 32.1 months -triple-negative and 10.6 months -HER2). Conclusion: MpBC is rare, reported only in up to 2% of all invasive breast cancers. Given its uncommon nature, pathology reports lack uniformity. Establishing protocols is crucial to accurately identifying and reporting patterns to better determine treatment strategies. Our data suggests better outcomes regarding Luminal-B, non-metastatic patients. However, the limited number of patients prevented a statistically significant evaluation of differences between histological subtypes. Multicentric studies are needed to correlate demographic, histological, or immunohistochemistry factors with patients’ outcomes.
- Sebaceous carcinoma in a mature cystic teratoma of the ovaryPublication . Fialho, M. Pinto; Gradil, A.; Ferreira, C.; Lérias, S.Background & objectives: Sebaceous carcinoma originating within an ovarian mature cystic teratoma (MCT) is an extremely rare entity. To the best of our knowledge, less than 14 cases have been reported in the literature. Methods: We report a case of a sebaceous carcinoma arising within a mature teratoma. Results: An 83-year-old female presented with urinary retention symptoms. A pelvic MRI scan revealed a left ovary lesion consistent with MCT. The patient underwent a bilateral adnexectomy. Macroscopically an 18cm ovary cystic mass showed a partially solid appearance intermixed with soft yellow sebaceous material. Histological examination revealed an MCT with a lobular component containing sebocytes surrounded by basaloid cells with focal squamoid features, nuclear pleomorphism, increased mitosis, and associated necrosis. Basaloid cells were immunoreactive to p63 and CK5/6. Sebaceous cells were EMA+ and PRAME+. Mismatch repair protein nuclear expression was intact. A diagnosis of a sebaceous carcinoma arising within an MCT was made. The patient is free of disease at 17 months. Conclusion: Sebaceous carcinoma within an ovarian MCT is a rare entity. Although ocular sebaceous carcinomas are aggressive, the prognosis of extraocular sebaceous carcinoma is thought to be better since local recurrence or metastasis has not yet been described. Given the paucity of data, the management of these patients remains unclear, however identifying tumor microsatellite instability or germline DNA mutations facilitates further cancer screening and treatment (PD1/PD-L1 inhibitors).