title: Her-2/neu evaluation in Sister Mary Joseph's nodule from breast carcinoma: a case report and review of the literature.
abstract: 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.
authors.affiliation: Department of Pathology, University of Verona, Verona, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Brunelli
authors.forename: Erminia
authors.initials: E
authors.lastname: Manfrin
authors.forename: Keith
authors.initials: K
authors.lastname: Miller
authors.forename: Albino
authors.initials: A
authors.lastname: Eccher
authors.forename: Stefano
authors.initials: S
authors.lastname: Gobbo
authors.forename: Daniela
authors.initials: D
authors.lastname: Reghellin
authors.forename: Marco
authors.initials: M
authors.lastname: Chilosi
authors.forename: Andrea
authors.initials: A
authors.lastname: Remo
authors.forename: Guido
authors.initials: G
authors.lastname: Martignoni
authors.forename: Fabio
authors.initials: F
authors.lastname: Menestrina
authors.forename: Franco
authors.initials: F
authors.lastname: Bonetti
mesh_terms: 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*
chemical_list: D014408:Biomarkers, Tumor; D018719:Erb-b2 Receptor Tyrosine Kinases