Rare Presentation of Papillary Carcinoma Within a Sentinel Lymph Node in a Patient With Ductal Carcinoma in Situ of the Breast: A Challenging but Useful Case Report Discussion Regarding Displacement or True Metastasis?

Int J Surg Pathol. 2024 Dec;32(8):1588-1594. doi: 10.1177/10668969241235316. Epub 2024 Mar 18.

Abstract

Papillary carcinoma of the breast is a rare histologic subtype of invasive breast cancer. In contrast, ductal carcinoma in situ (DCIS) is a noninvasive, nonobligate precursor to invasive mammary carcinoma, confined within the terminal duct lobular unit of the breast and surrounded by an intact myoepithelial cell layer at the stromal/epithelial interface. We present an unusual case in which a patient with only DCIS of the breast exhibited papillary carcinoma within a sentinel lymph node, leading to questions about the origin of the lymph node lesion-whether it represents a true metastasis or iatrogenic displacement during diagnostic procedures. This case underscores the diagnostic challenges and clinical implications associated with such rare presentations.

Keywords: breast; displacement; iatrogenic; lymph node; mechanical transport.

Publication types

  • Case Reports

MeSH terms

  • Breast Neoplasms* / diagnosis
  • Breast Neoplasms* / pathology
  • Carcinoma, Intraductal, Noninfiltrating* / diagnosis
  • Carcinoma, Intraductal, Noninfiltrating* / pathology
  • Carcinoma, Intraductal, Noninfiltrating* / surgery
  • Carcinoma, Papillary* / diagnosis
  • Carcinoma, Papillary* / pathology
  • Carcinoma, Papillary* / surgery
  • Female
  • Humans
  • Lymphatic Metastasis* / diagnosis
  • Lymphatic Metastasis* / pathology
  • Middle Aged
  • Sentinel Lymph Node Biopsy
  • Sentinel Lymph Node* / pathology
  • Sentinel Lymph Node* / surgery