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Metastatic hepatocellular carcinoma of the breast, simulating gynecomastia: Diagnosis by fine‐needle aspiration biopsy
Author(s) -
Nappi Oscar,
Ferrara Gerardo,
Lanniello Giovanni,
Wick Mark R.
Publication year - 1992
Publication title -
diagnostic cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.417
H-Index - 65
eISSN - 1097-0339
pISSN - 8755-1039
DOI - 10.1002/dc.2840080610
Subject(s) - medicine , pathology , gynecomastia , cytokeratin , fine needle aspiration , hepatocellular carcinoma , metastasis , biopsy , pancreas , neoplasm , metastatic carcinoma , cirrhosis , carcinoma , immunohistochemistry , cancer
Hepatocellular carcinoma (HCC) may uncommonly present with distant metastasis in the absence of a documented neoplasm in the liver. The authors herein describe the case of a 60‐year‐old man with cirrhosis who developed unilateral enlargement of the breast and a subareolar mass. This problem was clinically thought to represent gynecomastia, but a mammary fine‐needle aspiration biopsy demonstrated a malignant epithelial neoplasm composed of large granular amphophilic cells. Bile pigment was visualized in the tumor on aspirate smears and cell block preparations; immunostains showed reactivity for cytokeratin and alpha‐fetoprotein, but there was no positivity for epithelial membrane antigen, gross cystic disease fluid protein‐15, vimentin, estrogen receptors, progesterone receptors, or S100 protein. These results indicated a diagnosis of metastatic HCC, which was subsequently confirmed by computed tomography of the abdomen. © 1992 wiley‐Liss, Inc.