Special Types of Mammary Carcinoma 2

Abstract

Both primary and secondary carcinoid tumours of the breast have been described. There has been considerable interest in primary carcinoid tumours since the description by Cubilla and Woodruff¹ of ten cases (including two in the addendum) in 1977. In their series, the patients were all female, with a mean age of 54 years. Four of the ten patients had died with widespread metastatic tumour and a fifth was alive with disseminated disease. All the patients with tumours less than 2 cm in diameter were alive. Other reports of primary carcinoid tumours of the breast have sub-sequently appeared in the literature, including one in a male who had bilateral mammary neoplasms and an increased urinary excretion of norepinephrine². The tumours are usually well circumscribed. On histological examination they are composed of solid nests of cells with poorly defined outlines and a low mitotic rate, set within a very vascular stroma (Figure 15.1). Ribbon-like and glandular patterns also occur (Figures 15.2 and 15.3). Sometimes the cells show marked pleo-morphism (Figure 15.4). Argyrophil granules can be demonstrated by a modified Grimelius technique as shown in Figures 15.5 and 15.6, but argentaffin granules are usually absent. Neurosecretory granules can be indentified on electron microscopy in some cases.