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

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.