Her-2/neu evaluation in Sister Mary Joseph's nodule from breast carcinoma: a case report and review of the literature.
Sister Mary Joseph's nodule (SMJN) involving the umbilicus can often be a clinical sign of metastatic cancer, but rarely cancer originating from the breast. We report a rare case of umbilical metastases from breast cancer and reviewed the literature. A 54-year-old woman was referred to a pre-surgery clinic for an examination of an umbilical nodule. The patient had a history of ductal breast carcinoma. Cytological smear from fine needle aspiration showed epithelial neoplastic cells resembling those of breast carcinoma. Neoplastic cells from tissue were positive for cytokeratin 8-18, estrogen and progesterone receptor and negative for E-cadherin and had a low proliferative index. Her-2/neu immunodetection showed a 2+ equivocal positive rate, but Her-2/neu gene amplification was found on the cytological smear by fluorescence in situ hybridization analysis. Similar results were obtained within a tissue section. Concordant findings have been obtained when comparing the recent American Society of Clinical Oncology/College of American Pathologists scoring system. Fine needle aspiration from the SMJN is a useful tool for the diagnosis of metastatic breast cancer. Furthermore, the predictive biomarkers for tumors of the breast, hormonal receptors and Her-2/neu not only assist with the identification of the source of the metastatic disease but also provide clinical information for patient management.
Brunelli
Matteo
M
Department of Pathology, University of Verona, Verona, Italy.
Manfrin
Erminia
E
Miller
Keith
K
Eccher
Albino
A
Gobbo
Stefano
S
Reghellin
Daniela
D
Chilosi
Marco
M
Remo
Andrea
A
Martignoni
Guido
G
Menestrina
Fabio
F
Bonetti
Franco
F
D014408:Biomarkers, Tumor / Q000032:analysis / Q000235:genetics; D044963:Biopsy, Fine-Needle; D001943:Breast Neoplasms / Q000235:genetics / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000235:genetics / Q000556:secondary*; D005260:Female; D005784:Gene Amplification; D015870:Gene Expression; D018734:Genes, erbB-2; D020022:Genetic Predisposition to Disease; D006801:Humans; D007150:Immunohistochemistry; D017404:In Situ Hybridization, Fluorescence; D008875:Middle Aged; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000235:genetics / Q000378:metabolism*; D014472:Umbilicus / Q000473:pathology*
D014408:Biomarkers, Tumor; D018719:Erb-b2 Receptor Tyrosine Kinases