A rare case of large encapsulated papillary carcinoma of the male breast with a diagnostic challenge: A case report and literature review

Abstract

Introduction

Male breast carcinoma accounts for 1 % of all breast cancers. Encapsulated breast cancer (EPC) is a rare form of papillary breast cancer, accounting for 0.5 % to 2 % of all breast cancer. The aim of this case report is to highlight that EPC can present as a huge, mainly cystic lesion with a small solid focus, so that ultrasound-guided fine needle aspiration cytology (FNAC) should be done to avoid false negative results.

Presentation of case

We reported a 66-year-old male patient who presented with a right breast, painless, centrally located mass of 3 years duration. On an ultrasound examination, there was mainly a cystic retroareolar mass with a small solid focus measuring 10.5 cm × 8 cm × 5.9 cm. Initial cytology examination revealed a hemorrhagic aspirate, but subsequent ultrasound-guided FNAC concluded a papillary lesion. Simple mastectomy with sentinel lymph node biopsy was done, and subsequent histopathologic examination confirmed the diagnosis of encapsulated papillary carcinoma with negative lymph node status.

Discussion

EPC is one of the malignant papillary lesions of the breast, and it is considered a ductal carcinoma in situ. Diagnosis of EPC needs careful histopathologic examination and use of myoepithelial markers. EPC has a low locoregional and distant metastasis, and it is associated with an excellent prognosis.

Conclusion

In male patients presenting with large cystic breast lesions, EPC should be considered as a differential diagnosis, and ultrasound-guided FNAC should be done to make sure the solid focus is sampled.