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Int J Clin Exp Pathol 2013;6(7):1441-1444

Case Report
Pleomorphic lobular carcinoma in a male breast: a case report with review of the
literature

Mitsuaki Ishida, Tsuyoshi Mori, Tomoko Umeda, Yuki Kawai, Yoshihiro Kubota, Hajime Abe, Muneo Iwai, Keiko Yoshida, Akiko Kagotani, Tohru
Tani, Hidetoshi Okabe

Department of Clinical Laboratory Medicine and Division of Diagnostic Pathology, Shiga University of Medical Science, Shiga, Japan;
Department of Surgery, Shiga University of Medical Science, Shiga, Japan

Received May 13, 2013; Accepted May 28, 2013; Epub June 15, 2013; Published July 1, 2013

Abstract: Invasive lobular carcinoma (ILC) is a distinct type of breast carcinoma and represents 5-15% of invasive breast carcinomas in
female. However, the occurrence of ILC is exceptional in male breast, and the incidence is 1.5-1.9% of male breast carcinomas. Herein, we
report a case of pleomorphic lobular carcinoma in a male breast. A 76-year-old Japanese male with a history of treatment with a progestational
agent for prostate cancer presented with a right breast tumor. Magnetic resonance imaging showed gynecomastia of bilateral breasts and an
irregular-shaped nodule in his right breast. Histopathological study revealed infiltrative neoplastic growth of discohesive tumor cells arranged
in single-filed linear cords or trabeculae. These neoplastic cells had variable-sized large nuclei containing occasional nucleoli.
Immunohistochemically, these tumor cells lacked E-cadherin expression. Accordingly, an ultimate diagnosis of pleomorphic lobular carcinoma
was made. This is the third documented case of pleomorphic lobular carcinoma of male breast. Our analyses of the clinicopathological
features of this type of tumor revealed that patients were middle-aged or elderly men, and all cases were free from lymph node metastases or
recurrence. Gynecomastia and a history of hormonal agent intake were present only in the current case. The most commonly proposed risk
factor for the development of male breast cancer is elevated level of estrogen, and a possible link between the development of male breast
cancer and estrogen therapy for prostate cancer has been suggested. The clinicopathological features of ILC of male breast remains unclear;
therefore, additional studies are needed to clarify them. (IJCEP1305016).

Keywords: Lobular carcinoma, pleomorphic variant, male breast

Address correspondence to: Dr. Mitsuaki Ishida, Department of Clinical Laboratory Medicine and Division of Diagnostic Pathology, Shiga
University of Medical Science, Tsukinowa-cho, Seta, Otsu, Shiga, 520-2192, Japan. Phone: +81-77-548-2603; Fax: +81-77-548-2407; E-mail:
mitsuaki@belle.shiga-med.ac.jp