ADVANCED, RECURRENT, INVASIVE CRIBIFORM CARCINOMA OF THE BREAST IN A 17-YEAR-OLD MALE: A CASE REPORT

Male breast cancers (MBC) are relatively rare, accounting for about 1% of all male cancers in the US and 0.6% of breast cancers worldwide. In Nigeria, though the incidence varies per region, with a range of 3.4 to 9%, it is noted to be increasing. Gynaecomastia is a well-documented predisposing factor as well as endogenous and exogenous oestrogen. The most common histological subtype of male breast cancer is the invasive ductal carcinoma. Invasive cribriform carcinoma, ICC, is an extremely rare variant, with no more than 10 cases reported worldwide and, when present, has been diagnosed in patients above 40 years old.

We present the case of a 17 year-old, male undergraduate student, who presented to our clinic on account of a recurrent, painless, right breast lump. Three years earlier he had had a right breast lump excised at another health facilityand this was diagnosed histopathologicallyas invasive cribriform carcinoma. The only known predisposing factor was an initial lump, excised when he was 10 years old, and diagnosed histologically as gynaecomastia.He had surgical excision and axillary lymph node clearance,and histopathology re-confirmed high grade invasive cribriform carcinoma with multiple lymph node metastases, while immunohistochemistry showed a triple negative signature. He was thereafter referred for adjuvant treatment and has responded well to radiotherapy.

There is need for a high index of suspicion in all cases of gynaecomastia, and all such patients should be followed up. Prompt intervention, recourse to histology, and where indicated, immunohistochemistry, are important.