Secretory carcinoma of the breast in a nine year old boy

Carcinoma of the breast is very rare in childhood and is exceedingly rare i n boys. Secretory carcinoma, a distinctive and rare variant of breast carci noma is for some unknown reason the commonest type seen in children. To our knowledge there have been only four previous reports in boys under ten yea rs old. We report the first case in Australia of this unusual tumor in a ni ne year old boy, The child presented with a subareolar nodule 12mm in its g reatest dimension. High resolution sonography showed a well defined hypoech oic nodule. Histology revealed classical features of secretory carcinoma wi th circumscribed, pushing margins, except for one site of invasion. The tum or displayed the typical cribriform and microcystic pattern with PAS positi ve, diastase resistant secretions, and lack of pleomorphism and mitotic act ivity. Tumor cells showed positive staining with S100 and polyclonal CEA an d negative staining for estrogen and progesterone receptors. Although, beca use of its rarity, the natural history of this tumor is not well documented and optimal management is uncertain, prognosis happens to be excellent as these tumors behave in an indolent manner, both in children and in adults.