A Case of Bilateral Synchronous Apocrine Carcinomas Associated with Neurofibromatosis

Abstract

Neurofibromatosis (NF) is an autosomal dominant inheritable disease, characterized by café au lait skin macules and multiple neurofibromas. A 58-year-old woman presented with a left breast lump which was first recognized about six months earlier. The physical examination showed that she had neurofibromas in the skin over the whole body and bilateral breast tumors. She was diagnosed with left breast cancer (T2N0M0) and right apocrine sclerosing adenosis. Left modified radical mastectomy (Bt+SN→Ax) and right probe lumpectomy were performed. The final histological examination revealed bilateral synchronous apocrine carcinomas. Since the resected specimen from the right breast was positive at the margin, a right modified radical mastectomy (Bt) was also performed. Immunohistochemistry of resected specimens showed that estrogen, progesterone receptors and HER2 were negative, but androgen receptors were positive. Bilateral breast cancers associated with NF have been reported recently and we concluded that bilateral synchronous breast cancers associated with NF must be carefully diagnosed and surgically removed.