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Case 1 History: A 53 year-old woman presented with a frontal-parietal lobe intra-axial tumor.

Diagnostic Challenge Pathology for Neurosurgery & Neurology Residents Department of Pathology University of Oklahoma Health Sciences Center, Oklahoma City, OK, U.S.A. Case 1 History: A 53 year-old woman presented with a frontal-parietal lobe intra-axial tumor.

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Case 1 History: A 53 year-old woman presented with a frontal-parietal lobe intra-axial tumor.

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  1. Diagnostic ChallengePathology for Neurosurgery & Neurology ResidentsDepartment of PathologyUniversity of Oklahoma Health Sciences Center,Oklahoma City, OK, U.S.A. Case 1 History: A 53 year-old woman presented with a frontal-parietal lobe intra-axial tumor. Contributor: Kar-Ming Fung, M.D., Ph.D., karming-fung@ouhsc.edu Last updataded: 1/9/2009

  2. Frozen Section Cytologic Preparation A B

  3. Paraffin Section Paraffin Section C D

  4. Thyroid transcription factor-1 (TTF-1) Gross cystic disease fluid protein-15 (GCDFP-15) E F

  5. What is your diagnosis?

  6. Diagnosis: Metastatic adenocarcinoma of breast origin. • Discussion: • The cells are highly pleomorphic with large nuclei and nucleoli (Panel A and B). The cytologic features are best appreciated in the cytologic preparation (Panel B). • The tumor cells form solid sheets. In between the tumor cells are small glands that contain mucin (arrow in the panel on the right). • The glandular structure are well demonstrated in permanent sections (Panel C). There are also necrosis (Panel D). • Putting all of these together, the features are most consistent with a metastatic adenocarcarcinoma. • The patient has a history of breast carcinoma. The positive immunoreactivity of GCDFP-15 confirmed the breast origin. Breast carcinoma are usually negative for TTF-1.

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