PMC8387079_01
A - Mammography in craniocaudal; and B - mediolateral oblique views, showing a solid irregular lesion with 50x26 mm in the upper outer quadrant of the left breast, suspicious for malignancy.
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Photomicrograph of the microbiopsy of the left breast lesion consistent with: A - Invasive carcinoma with 60% of ducts, high nuclear pleomorphism, 4-5 mitoses for 10 high power fields, with no evidence of vascular or perineural infiltration. Images of ductal carcinoma in situ with high nuclear grade and comedocarcinoma. Histology compatible with the diagnosis of invasive ductal carcinoma (H&E x40); B - immunohistochemistry positivity for estrogen-receptor expression (x100); C - progesterone-receptor positive expression (x100).
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A - Mammography in craniocaudal; B - and mediolateral oblique views, showing partial response to palbociclib in association with letrozole plus goserelin.
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A dimension reduction to 31x10 mm (previous: 50x26 mm) was observed, corresponding to a partial response by RECIST 1.1 Criteria (Figure 3).
Photomicrographs of liver biopsy showing: A - hepatic parenchyma occupied by well-differentiated neuroendocrine tumor (H&E x100); immunohistochemistry analysis showing positivity for B - AE1 / AE3, a broad-spectrum cytokeratin positive in epithelial neoplasms (x100); C and D - positivity for synaptophysin and CD56, both neuroendocrine markers (x100).
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The immunohistochemistry of the first liver biopsy was reviewed and was also compatible with hepatic metastasis of a neuroendocrine tumor (Figures 4 and 5).
Photomicrographs of liver biopsy showing: A - positivity for CDX2, a specific marker of intestinal epithelial cells (x100); B - negativity for TTF1, a marker typically negative in extrapulmonary neuroendocrine tumors (x100); C - Less than 1% of the tumor cell population was positive for Ki67 expression (x100).
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The immunohistochemistry of the first liver biopsy was reviewed and was also compatible with hepatic metastasis of a neuroendocrine tumor (Figures 4 and 5).
PET 68Ga-DOTANOC showing A - liver metastases; and B - a primary tumor in the ileocecal topography with high expression of somatostatin receptors.
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