Tall cell carcinoma with reversed polarity: A case report of a very rare breast tumor entity and mini‐review

Abstract

Tall cell carcinoma with reversed polarity (TCCRP) is a very rare variant of carcinoma of the breast, resembling the tall cell variant of papillary thyroid carcinoma, first described in 2003, recently recognized as a separate entity in the 5th edition of the WHO (World Health Organization) Blue Book Classification of breast tumors with alternative terminology of tall cell variant of papillary breast carcinoma and solid papillary carcinoma with reversed polarity. Here, we report an additional case of this rare tumor in a 71‐year‐old woman, and the problems correlating with its diagnosis.

Tall cell carcinoma with reversed polarity of breast: Sonographic and magnetic resonance imaging findings

“…Immunohistochemically, TCCRP typically shows the ER and PR negative and c‐erb‐2/HER‐2 negative phenotype, so‐called triple negative. Some of the reported cases showed weak or focal hormone receptor expression but almost all reported cases were HER‐2 negative 5–7 . TCCRP also shows negative myoepithelial markers and intense reactivity for high weight cytokeratins (CK5/6).…”

“…Some of the reported cases showed weak or focal hormone receptor expression but almost all reported cases were HER-2 negative. [5][6][7] TCCRP also shows negative myoepithelial markers and intense reactivity for high weight cytokeratins (CK5/6). Usually Ki-67 index of the tumor is less than 20%, which are low or intermediate grade tumors.…”

“…This entity of breast cancer shows specific morphologic, immunohistochemical, and molecular features 8 . Initially, because it resembles the pathologic finding of tall cell variant of papillary thyroid carcinoma (PTC), it was called breast tumor resembling the tall cell carcinoma variant of papillary thyroid carcinoma (BTRTPC), tall cell variant of papillary breast carcinoma (TCVPBC), and solid papillary neoplasm/carcinoma with reverse polarity (SPNRP) 6–9 . The new terminology “TCCRP” was proposed because it could be misunderstood that this subtype of breast cancer was related to papillary thyroid cancer 6,7,9 .…”

“…TCCRP is frequently associated with specific IDH2 and PIK3CA mutations 4 . It usually occurs in postmenopausal women with an average age of 64 years, ranges from 39 to 89 6 . The clinical manifestation of TCCRP can vary; however, it is commonly diagnosed through a palpable breast mass or incidental finding on screening mammography 5 .…”

“…Tall cell carcinoma with reversed polarity (TCCRP) of breast is an uncommon subtype of breast cancer. Since Eusebi et al 1 published five cases in 2003, called “breast tumor resembling the tall cell variant of papillary thyroid cancer (BTRPTC)”, approximately 78 cases in 20 published papers were reported by 2021 1–7 . TCCRP frequently shows a triple negative profile, but indolent behavior with a good prognosis and is not associated with thyroid gland neoplasms.…”