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Metaplastic Carcinoma of Breast with Osteosarcomatous Differentiation: A Rare Case Diagnosed by Fine Needle Aspiration Cytology

Archana Ticku and Prem Singh

Metaplastic carcinoma is a rare form of breast cancer. It constitutes a distinct aggressive form of invasive breast cancer with histological evidence of epithelial to mesenchymal transition towards spindle, chondroid or osseous cell type. Osseous metaplasia is an exceptionally rare component in metaplastic breast carcinoma. We present a case of 40 yr old female who was diagnosed with Metaplastic carcinoma of breast on fine needle aspiration cytology (FNAC) and subsequently confirmed by histopathological examination. The patient reported to our institution with complaints of painless left breast lump of 5 yr duration. USG findings revealed large infiltrative hypoechoic mass in left upper quadrant of breast suggestive of malignancy. FNAC of lump showed loosely cohesive clusters of malignant spindle cells along with multinucleated giant cell in background of chondroid stroma. A tentative diagnosis of metaplastic carcinoma breast was made. Modified radical mastectomy was performed. Histopathological examination of specimen revealed presence of osteoid lined by malignant osteoblasts like cells interspersed with multinucleated giant cells.
A diagnosis of metaplastic carcinoma of breast with osteosarcomatous differentiation was confirmed on histopathological examination. Metaplastic breast carcinoma are heterogenous group of tumors constituting 0.2% of breast carcinomas. Age group and clinical features and radiographic features are similar to other invasive breast carcinomas. Cases is presented for its rarity and utility of FNAC in diagnosing such cases having divergent histological features.