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CC BY 4.0 · Indian J Med Paediatr Oncol
DOI: 10.1055/s-0045-1811526
Case Report with Review of Literature

Tall Cell Carcinoma with Reversed Polarity in the Breast: A Case Report with Review of Literature

Meryl Saji Kottarathil 
1   Department of Pathology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
,
Subalakshmi Balasubramanian
1   Department of Pathology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
,
Sandhya Sundaram
1   Department of Pathology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
,
M. Manickavasagam
2   Department of Medical Oncology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
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Abstract

Tall cell carcinoma with reversed polarity (TCCRP) is a relatively new entity that is recognized as a subtype of epithelial tumors of the breast in the latest World Health Organization classification of breast tumors (fifth edition). This tumor bears close morphological resemblance to the tall cell subtype of papillary carcinoma of the thyroid. TCCRP is recognized by its distinct morphologic and immunohistochemical patterns, occasionally aided by molecular analysis for the presence of associated characteristic IDH2 mutations.

A 42-year-old woman with a left breast lump was evaluated at another institute and diagnosed with invasive mammary carcinoma (no special type), and subsequently underwent a modified radical mastectomy. Our institute received the case for review. On histopathological examination, the sections revealed a fairly circumscribed lesion composed of nests of tall cells with apically located nuclei. After correlation with immunohistochemistry markers, a diagnosis of TCCRP was established. The patient was further managed with adjuvant chemotherapy and was declared disease-free on 1-year follow-up.

We report this lesion as it is a novel breast tumor, and a thorough understanding of its morphological appearance is essential to establish the diagnosis. A lack of awareness may result in misdiagnosis, with the lesion possibly being categorized as a nonspecific malignancy or misinterpreted as another papillary breast lesion. Given its favorable prognosis, accurate diagnosis of this tumor is imperative. When evaluating papillary breast lesions, TCCRP should be a key differential consideration.

Keywords

tall cell carcinoma - IDH2 mutation - TCCRP - reversed polarity - case report

Authors' Contributions

M.S.K. was involved in data collection, manuscript preparation, and literature search. S.B. contributed to manuscript preparation and manuscript editing. S.S. gave the concept design and was involved in manuscript editing and final manuscript review. M.M. contributed to manuscript review and clinical treatment. All authors have read and approved the final manuscript and believe that the manuscript represents honest work.


Patient's Consent

Written informed consent was obtained from the patient for the publication of this case report, including clinical details, pathological findings, and associated images. The patient understands that their identity will be protected, and the information will be used for educational and scientific purposes.




Publication History

Article published online:
22 August 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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  • References

  • 1 Yang WT, Bu H, Foschini MP, Schnitt SJ. Tall cell carcinoma with reversed polarity. In: WHO Classification of Tumours Editorial Board, eds. WHO Classification of Tumours: Breast Tumours. 5th ed.. Lyon (France): International Agency for Research on Cancer; 2019: 153-154
    Search in Google Scholar
  • 2 Eusebi V, Damiani S, Ellis IO, Azzopardi JG, Rosai J. Breast tumor resembling the tall cell variant of papillary thyroid carcinoma: report of 5 cases. Am J Surg Pathol 2003; 27 (08) 1114-1118
    CrossrefPubMedSearch in Google Scholar
  • 3 Lozada JR, Basili T, Pareja F. et al. Solid papillary breast carcinomas resembling the tall cell variant of papillary thyroid neoplasms (solid papillary carcinomas with reverse polarity) harbour recurrent mutations affecting IDH2 and PIK3CA: a validation cohort. Histopathology 2018; 73 (02) 339-344
    CrossrefPubMedSearch in Google Scholar
  • 4 Masood S, Davis C, Kubik MJ. Changing the term “breast tumor resembling the tall cell variant of papillary thyroid carcinoma” to “tall cell variant of papillary breast carcinoma”. Adv Anat Pathol 2012; 19 (02) 108-110
    CrossrefPubMedSearch in Google Scholar
  • 5 Colella R, Guerriero A, Giansanti M, Sidoni A, Bellezza G. An additional case of breast tumor resembling the tall cell variant of papillary thyroid carcinoma. Int J Surg Pathol 2015; 23 (03) 217-220
    CrossrefPubMedSearch in Google Scholar
  • 6 Zhang X, Wu H, Wang Z. et al. Tall cell carcinoma of the breast with reverse polarity: case report with gene sequencing and literature review. Gland Surg 2021; 10 (02) 837-843
    CrossrefPubMedSearch in Google Scholar
  • 7 Matute G, Barcenas L, Bautista C, Restrepo Ramirez CA, Llinas Quintero N. Tall cell carcinoma with reversed polarity of the breast. Cureus 2021; 13 (08) e16814
    PubMedSearch in Google Scholar
  • 8 Tosi AL, Ragazzi M, Asioli S. et al. Breast tumor resembling the tall cell variant of papillary thyroid carcinoma: report of 4 cases with evidence of malignant potential. Int J Surg Pathol 2007; 15 (01) 14-19
    CrossrefPubMedSearch in Google Scholar
  • 9 Foschini MP, Asioli S, Foreid S. et al. Solid papillary breast carcinomas resembling the tall cell variant of papillary thyroid neoplasms: a unique invasive tumor with indolent behavior. Am J Surg Pathol 2017; 41 (07) 887-895
    CrossrefPubMedSearch in Google Scholar
  • 10 Chiang S, Weigelt B, Wen HC. et al. IDH2 mutations define a unique subtype of breast cancer with altered nuclear polarity. Cancer Res 2016; 76 (24) 7118-7129
    CrossrefPubMedSearch in Google Scholar
  • 11 Lei Z, Wang YX, Wang ZY, Yang CG, Pan GQ. Case report: Tall cell carcinoma with reversed polarity of the breast: an additional case and review of the literature. Front Oncol 2024; 14: 1302196
    CrossrefPubMedSearch in Google Scholar
  • 12 Jassim M, Premalata CS, Okaly G, Srinivas C. Tall cell carcinoma with reverse polarity of breast: report of a case with unique morphologic and molecular features. Turk Patoloji Derg 2021; 37 (02) 183-188
    PubMedSearch in Google Scholar
  • 13 Zhong E, Scognamiglio T, D'Alfonso T. et al. Breast tumor resembling the tall cell variant of papillary thyroid carcinoma: molecular characterization by next-generation sequencing and histopathological comparison with tall cell papillary carcinoma of thyroid. Int J Surg Pathol 2019; 27 (02) 134-141
    CrossrefPubMedSearch in Google Scholar
  • 14 Alsadoun N, MacGrogan G, Truntzer C. et al. Solid papillary carcinoma with reverse polarity of the breast harbors specific morphologic, immunohistochemical and molecular profile in comparison with other benign or malignant papillary lesions of the breast: a comparative study of 9 additional cases. Mod Pathol 2018; 31 (09) 1367-1380
    CrossrefPubMedSearch in Google Scholar
  • 15 Wei Y, Ding L, Song X. et al. Tall cell carcinoma with reversed polarity: case report with gene sequencing and literature review. Gland Surg 2021; 10 (11) 3147-3154
    CrossrefPubMedSearch in Google Scholar
  • 16 Pareja F, da Silva EM, Frosina D. et al. Immunohistochemical analysis of IDH2 R172 hotspot mutations in breast papillary neoplasms: applications in the diagnosis of tall cell carcinoma with reverse polarity. Mod Pathol 2020; 33 (06) 1056-1064
    CrossrefPubMedSearch in Google Scholar
  • 17 Marotti JD, Schnitt SJ. Genotype-phenotype correlations in breast cancer. Surg Pathol Clin 2018; 11 (01) 199-211
    CrossrefPubMedSearch in Google Scholar
  • 18 Toss MS, Billingham K, Egbuniwe IU, Moreno F, Abass A, Rakha EA. Breast tumours resembling the tall cell variant of thyroid papillary carcinoma: are they part of the papillary carcinoma spectrum or a distinct entity?. Pathobiology 2019; 86 (2-3): 83-91
    CrossrefPubMedSearch in Google Scholar
  • 19 Bhargava R, Florea AV, Pelmus M. et al. Breast tumor resembling tall cell variant of papillary thyroid carcinoma: a solid papillary neoplasm with characteristic immunohistochemical profile and few recurrent mutations. Am J Clin Pathol 2017; 147 (04) 399-410
    CrossrefPubMedSearch in Google Scholar