Dhiraj B Nikumbh, et al. Unusual mixed invasive tubulo-lobular carcinoma of the breast International Journal of Medical Science and Public Health | 2014 | Vol 3 | Issue 8 (Online First) TUBULO-LOBULAR CARCINOMA: AN UNUSUAL MIXED INVASIVE CARCINOMA OF THE BREAST Dhiraj B Nikumbh, Shivraj N Kanthikar, Akshay Surana Department of Pathology, JMF’S ACPM Medical College, Dhule, Maharashtra, India Correspondence to: Dhiraj B Nikumbh (drdhirajnikumbh@rediffmail.com) DOI: 10.5455/ijmsph.2014.250420141 ABSTRACT Tubulo-lobular carcinoma is a rare variant of mammary carcinoma that displays an admixture of invasive tubules and lobular like cells. It accounts for 1% of breast cancers with dual growth pattern of tubular carcinoma and invasive lobular carcinoma. Tubulo- lobular carcinoma appears to be rare aggressive tumour than tubular carcinoma, but with overall good prognosis. Herein we report a case of 60-year-old female with right breast mass since 4 months. Histopathologically proved as Tubulo-lobular carcinoma; an unusual mixed invasive carcinoma o the breast. We highlight the importance of histopathology for diagnosis of such rare tumours of breast in view of its mixed histopathology and uncertain biological behaviour. Hence better understanding of Tubulo-lobular carcinoma would enable pathological diagnosis to be made regularly and accurately. Key Words: Tubulo-Lobular Carcinoma; Breast Cancer; Mixed Carcinoma Introduction Tubulo-lobular carcinoma is a unique form of invasive breast carcinoma exhibiting both ductal and tubular differentiation. [1] The neoplasm exhibits small tubules as well as cords of neoplastic cells in a lobular configuration reminiscent of lobular invasive carcinoma. [2] Fisher et al. concluded that this lesion represents a tubular variant of lobular invasive carcinoma in 1977. [2] Tubulo-lobular carcinoma is a rare variant of invasive breast cancer and reveals mixed histological features of both tubular and lobular carcinoma with common expression of E- Cadherin, CK-8 and CK34-Beta E12. [13] A better understanding of Tubulo-lobular would enable pathological diagnosis to be made regularly and accurately. [13] We report a case of Tubulo-lobular carcinoma of breast in a 60-year old female. Little is known about Tubulo- lobular carcinoma. The goal of this case report is to advent to this unusual clinical and histopathological diagnosis, to review and discuss diagnostics, differential diagnosis and treatment options. Case Report A 60-year-old female presented to surgical OPD of our hospital with lump in her right breast since 4 months. There was no significant past, personal and family history. The lump was insidious in onset and painless with gradual increase in size. On local examination, the lump measured 4x4 cm in the periareolar and lower anterior quadrant of right breast. The skin, nipple and areola were normal. Other breast was unremarkable. Right axillary nodes were palpable. Cytology of mass advised by Surgeon which was positive for malignant cells. On admission, her vital were stable and routine investigation such as complete blood count and biochemical and chest X-Ray were within normal limits. She was immunonegative for HIV, HBsAg and HCV. Right sided modified radical mastectomy with axillary dissection was carried and specimen was sent for histopathology. The post-operative period was uneventful. Figure-1: Gross appearance Right MRM specimen with elliptical piece of skin Gross Findings We received right MRM specimen totally measuring CASE REPORT