Osteoclast-like Multinucleated Giant Cells

A Clue to Invasive Mammary Carcinoma

  • Prachi Bhaurao Nichat Metropolis Healthcare Ltd., Mumbai, India
  • Kirti Chadha Kazi Metropolis Healthcare Ltd., Mumbai, India
  • Prem Punjabi Consultant Pathologist
  • Vikas Kavishwar Metropolis Healthcare Ltd., Mumbai, India
Keywords: mammary carcinoma, osteoclast-like, giant cells, low grade


Mammary carcinoma with osteoclast-like giant cells is a rare variant of infiltrating breast carcinoma, first described by Rosen in 1979. Clinically and on sonomammography, the well-circumscribed margin of these tumors may suggest a benign lesion such as fibroadenoma and lead to a false negative diagnosis, as in this case of a 46 year old female with right breast lump. Fine needle aspiration cytology showed cohesive clusters with minimal cellular atypia mimicking fibroadenoma. But, presence of osteoclast-like multinucleated giant cells in the background was puzzling. So, lumpectomy was performed. Histopathology showed well differentiated invasive duct carcinoma, confirmed as luminal A type on immunohistochemistry. Till date, over 200 cases have been reported worldwide but we describe probably the only case from India, with complete work-up. The purpose of sharing this experience is to avoid missing malignancy on cytology in lesions which radiographically mimic fibroadenoma, osteoclast-like giant cells being a clue. Immunohistochemistry plays a diagnostic and predictive role. This low grade, rare but unique breast carcinomas must be documented for optimal patient management.

Author Biographies

Prachi Bhaurao Nichat, Metropolis Healthcare Ltd., Mumbai, India
Department of Surgical Pathology
Kirti Chadha Kazi, Metropolis Healthcare Ltd., Mumbai, India
Head Of Department, Surgical Pathology
Prem Punjabi, Consultant Pathologist
Senior Consultant Pathologist
Vikas Kavishwar, Metropolis Healthcare Ltd., Mumbai, India
Senior Consultant Histopathologist, Department of Surgical Pathology


1. Rosen PP. Multinucleated mammary stromal giant cells: a benign lesion that simulates inva¬sive carcinoma. Cancer 1979; 44: 1305-1308.
2. Ellis IO, Collins L, Ichihara S, MacGrogen G. Invasive carcinoma of no special type. In: World Health Organization Classification of Tumors of the Breast, Lakhani SR, Ellis IO, Schnitt SJ, Tan PH et al. 4th edition, IARC Press, Lyon, France, 2012:36–37.
3. Bauditz J., Rudolph B., Wermke W. Osteoclast-like giant cell tumors of the pancreas and liver. World Journal of Gastroenterology. 2006; 12:7878–7883.
4. Baschinsky DY, Frankel WL, Niemann TH. Gastric carcinoma with osteoclast-like giant cells. American Journal of Gastroenterology 1999; 94:1678-1681.
5. Kobayashi S, Yamadori I, Ohmori M, Kurokawa T, Umeda M. Anaplastic carcinoma of the thyroid with osteoclast-like giant cells. An ultrastructural and immunohistochemical study. Acta Pathol Jpn. 1987 May; 37(5):807-15.
6. Holland R, van Haelst UJ. Mammary carci¬noma with osteoclast-like giant cells. Additional observations on six cases. Cancer 1984; 53: 1963-1973.
7. Cai N, Koizumi J, Vazquez M. Mammary carcinoma with osteoclast-like giant cells: a study of four cases and a review of literature. Diagn Cytopathol 2005; 33: 246-251.
8. Chapter 23 - Mammary Carcinoma with Osteoclast-Like Giant Cells. In: Rosen's Breast Pathology. Rosen PP. 3rd Edition, Lippincott Williams & Wilkins 2009: 571-580.
9. Krishnan C, Longacre TA. Ductal carcinoma in situ of the breast with osteoclast-like giant cells. Human pathology 2006; 37: 39-372.
10. Zhou, S., Yu, L., Zhou, R. et al. Virchows Arch 2014; 464: 681. doi: 10.1007/s00428-014-1573-y
11. Agnantis NT, Rosen PP. Mammary carcinoma with osteoclast-like giant cells: A study of eight cases with follow up data. Am J Clin Pathol 1979; 72:383-389.
Case Report