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Case Reports 2018
Medical Case Reports
ISSN: 2471-8041
Page 28
May 28-29, 2018
London, UK
8
th
Edition of International Conference on
Clinical and Medical Case Reports
Background:
Lobular carcinoma
in situ
(LCIS) is an unusual lesion
of the breast that is a neoplasia rather than a carcinoma. Almost
all cases of LCIS lack any pleomorphism or necrosis. A PubMed
library search into cases of LCIS with necrosis found one valid
result, which documents just 18 cases of LCIS with necrosis
from the recent databases of six tertiary institutions in the US.
When immunohistochemistry confirms LCIS with necrosis, the
management plan shifts away from watchful waiting and more
towards surgical intervention.
Case report:
We report the case of a 43-year-old lady who
presented with a right breast mass. An initial mammogram
showed somemicrocalcificationfibrocystic changes. Subsequent
histology and immunohistochemistry confirmed LCIS with
necrosis. Due to the atypical finding of necrosis in conjunction
with LCIS, a decision was made to perform further random
core biopsies. This confirmed a more sinister underlying mixed
lobular and ductal type carcinoma. Reassuringly, US and MRI
excluded involvement of the other breast and metastatic disease.
A nipple sparing mastectomy and sentinel lymph node biopsy
plus immediate reconstruction on the right side was performed
followed by adjuvant tamoxifen. 12 months on, the patient is well
with no complications.
Conclusion:
This case highlights the importance of utilising
multiple diagnostic techniques and a prudent histologic
examination when a breast lump is in question. LCIS associated
with necrosis is rare, but should raise suspicions of an underlying
cancer. One way of investigating this would be to perform further
random core biopsies and other modalities of investigation with a
view to finding further cancer.
Biography
KirupakaranSilasArun is an FY1 inGeneral Surgeryworking atWhippsCross
Hospital in London. He graduated from University of Cambridge with a dis-
tinction (ranked 2nd in his year) and he intercalated in Pharmacology and
achieved a 1st class degree, being ranked 5th of all students. He has a keen
interest in medical education. At the age of 18, he became the youngest UK-
CAT & BMAT tutor for Kaplan Test Prep and admissions, and was appointed
as Lead Tutor for UKCAT & BMAT in 2013. In 2015, he established his own
company ‘Easy Medical Interviews’ that provides live and online courses for
prospective medical students. Over the last five years, he has helped over
1500 students get into medical school whether it be through UKCAT/BMAT
tutoring, polishing and refining personal statements or providingmock inter-
views. In the future, he intends to pursue a career in Ophthalmology, whilst
being heavily involved in academic research and medication education.
arunkiru@doctors.org.ukLobular carcinoma in situ with necrosis – does this indicate
an underlying carcinoma?
Kirupakaran Silas Arun
University of Cambridge, UK
Kirupakaran Silas Arun, Med Case Rep. 2018, Volume 4
DOI:10.21767/2471-8041-C1-002