Large encapsulated papillary carcinoma presenting as an arteriovenous malformation
Keywords:Encapsulated, Papillary, Carcinoma, EPC, Vascular, Malformation
Encapsulated papillary carcinomas (EPCs) are a rare breast tumour that carry a good prognosis. They are typically 0.5-8.0 cm in size and commonly present with a painless mass and bloody nipple discharge. We present an 80-year-old female with a 15.0 cm EPC, the largest reported in literature, that presented with an expanding breast haematoma and a distant history of breast trauma. Anaemic symptoms post initial aspiration, previous arterial injury to the same breast and prominent feeding vessels to the mass seen on both imaging, and at time of mastectomy, raise the differential of underlying vascular malformation.
Steponaviciene L, Gudaviciene D, Briediene R, Petroska D, Garnelyte A. Diagnosis, treatment, and outcomes of encapsulated papillary carcinoma: a single institution experience. Acta Med Litu. 2018;25(2):66-75.
Reefy SA, Kameshki R, Sada DA, Elewah AA, Awadhi AA, Awadhi KA. Intracystic papillary breast cancer: a clinical update. E-cancermedicalscience. 2013;7:286.
Wynveen CA, Nehhozina T, Akram M, Hassan M, Norton L, Van Zee KJ, et al. Intracystic papillary carcinoma of the breast: An in situ or invasive tumor? Results of immunohistochemical analysis and clinical follow-up. Am J Surg Pathol. 2011;35(1):1-14.
Esposito NN, Dabbs DJ, Bhargava R. Are encapsulated papillary carcinomas of the breast in situ or invasive? A basement membrane study of 27 cases. Am J Clin Pathol. 2009;131(2):228-42.
Li B, Nguyen J, Williams CA, Cardenas K, Pidhorecky I. Rare Papillary Breast Carcinoma Incidentally Discovered After Trauma-Induced Hematoma. Cureus. 2021;13(9):e18215.
Yoneyama K, Nakagawa M, Hara A. A case of encapsulated papillary carcinoma of the breast treated with emergency surgery due to sudden hemorrhage. Int J Surg Case Rep. 2019;65:201-4.
Joseph KA, Ditkoff BA, Komenaka I, Mercado CL, Millman SL, Lantis J, et al. Acquired arteriovenous fistula of the breast. Breast J. 2004;10(2):156-8.
Ko KH, Kim EK, Park BW. Invasive papillary carcinoma of the breast presenting as post-traumatic recurrent hemorrhagic cysts. Yonsei Med J. 2006;47(4):575-7.
George K, Anna Z, Evanthia K, Vassilios K. Encapsulated papillary carcinoma of the breast: An overview. J Cancer Res Ther. 2013;9(4):564-70.