PMC3980508_01
Preoperative imaging. Top: ultrasound showing a hypoechoic homogeneous solid nodule with posterior acoustic enhancement (yellow gallons) and color Doppler showing peripheral and penetrating vascular network. Bottom: contrast-enhanced axial computed tomography image of the chest show an enhancing, homogeneous right breast mass (red arrow). (For interpretation of the references to color in this figure legend, the reader is referred to the web version of the article.)
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A contrast-enhanced whole body CT showed an enhancing, homogeneous right breast mass (Fig. 1), and fine needle aspiration citology (FNAC) was unable to show malignancy.
Histology (H&E, 5x) clear cell carcinoma (left) metastatic to the breast (right).
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A tru-cut biopsy was then performed and revealed a tumor composed of nests and cords of cells with clear cytoplasm separated by a prominent sinusoidal vascular network (Fig. 2), which showed, at immunohistochemistry, positive vimentin and CD10 staining while CK7 and CK20 were negative.
Gross anatomy of metastasis to the breast from Renal Cell Carcinoma (RCC); see text for description.
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Such pattern was consistent with Renal Cell Carcinoma of clear cell type (Fig. 3).