title: Centrally necrotizing breast carcinoma: a rare histological subtype, which was cause of misdiagnosis in an evident clinical local recurrence.
abstract: Centrally necrotizing carcinoma is a rare subtype of breast carcinoma, which is characterized by an extensive central necrotic zone accounting for at least 70% of the cross-sectional area of the neoplasm. This central necrotic zone, in turn, is surrounded by a narrow rim of proliferative viable tumor cells. We report an unusual clinical situation in which a patient whose evident breast mass suggested an ipsilateral local recurrence and for which numerous attempts to confirm the histological diagnosis had failed. The patient was treated with a radical mastectomy based on clinical suspicion of breast cancer recurrence after an undesirable delay. In this case, the narrow rim of viable malignant tissue had a thickness of 0.5 to 8 mm, and the centrally necrotizing carcinoma had a central zone with a predominance of fibrosis. The special features of this case led to a misdiagnosis and to an evident clinical local recurrence.
authors.affiliation: Department of Surgery, Valdecilla Hospital, Spain. hernanzf@unican.es
authors.forename: Fernando
authors.initials: F
authors.lastname: Hernanz
authors.forename: Pilar
authors.initials: P
authors.lastname: Alonso-Bartolomé
authors.forename: Irene
authors.initials: I
authors.lastname: González-Rodilla
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis* / Q000628:therapy; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis* / Q000628:therapy; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D008875:Middle Aged; D009336:Necrosis; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000628:therapy; D009367:Neoplasm Staging; D011379:Prognosis; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism
chemical_list: D011960:Receptors, Estrogen; D011980:Receptors, Progesterone