title: An 18-year-old woman with a 34-cm metaplastic breast carcinoma.
abstract: Metaplastic breast carcinomas (MBCs) are rare malignancies usually with poor prognosis. We report a case of an 18-year-old African female patient who presented with a 34-cm tumor on the right breast. Biopsy showed an extensively necrotic MBC negative for estrogen receptor, progesterone receptor and human epidermal growth factor receptor 2 (triple negative). A modified right radical mastectomy was performed, followed by adjuvant chemotherapy. Histology confirmed a widely necrotic undifferentiated malignant tumor, with strong and diffuse expression of vimentin and B-cell lymphoma 2, focal high-molecular-weight keratins and focal CD34 expression; Ki67 was >90%. There was no skin, deep margin or lymph node involvement. Six months after surgery, the patient showed a 9 × 7 cm nodule adjacent to the suture and adherent to the anterior chest wall. The tumor was considered unresectable and the patient evolved with rapid systemic deterioration. The patient had a progression-free survival of 6 months and overall survival of 9 months.
authors.affiliation: B Surgery Department, Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal apspgomes@gmail.com.
authors.forename: António
authors.initials: A
authors.lastname: Gomes
authors.affiliation: Gynecology/Senology Department, Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Santos
authors.affiliation: Gynecology/Senology Department, Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal.
authors.forename: Gonçalo
authors.initials: G
authors.lastname: Dias
authors.affiliation: Pathology Department, Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal.
authors.forename: Rita Theias
authors.initials: RT
authors.lastname: Manso
authors.affiliation: Pathology Department, Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal.
authors.forename: Lucília
authors.initials: L
authors.lastname: Gonçalves
authors.affiliation: Gynecology/Senology Department, Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal.
authors.forename: Margarida
authors.initials: M
authors.lastname: Coiteiro
authors.affiliation: Gynecology/Senology Department, Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal.
authors.forename: Helena
authors.initials: H
authors.lastname: Gaspar
authors.affiliation: Gynecology/Senology Department, Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal.
authors.forename: Antónia
authors.initials: A
authors.lastname: Nazaré