# Tall cell carcinoma with reversed polarity of breast cancer: a rare case report and review of the literature

## TL;DR

This paper reports the 83rd case of a rare breast cancer type called TCCRP and identifies specific genetic mutations that may help guide treatment.

## Contribution

The paper presents the first case of TCCRP with genetic testing, identifying new mutations and macrophage markers.

## Key findings

- The case shows a PIK3CA p.H1047R and IDH2 R172T mutation in TCCRP.
- CD68/CD163 double-positive macrophages were found, suggesting a poor prognosis.
- The patient received postoperative radiotherapy and remains recurrence-free.

## Abstract

Tall cell carcinoma with reversed polarity (TCCRP) is a primary invasive breast cancer that is clinicopathologically characterized by reversed polarity of the nucleus of the tumor cells near the cell edge. This pathologic feature is so rare that only 82 cases of TCCRP have been reported worldwide since it was first reported in 2003. Herein, we present the 83rd case of TCCRP. Going one step further than the previous reports, our case includes genetic testing. We sought to explore whether there are new mutation sites, with a view to identifying more therapeutic options for patients in future, to find PIK3CA p.H1047R mutation and IDH2 R172T mutation.We have found the macrophase makers CD68/CD163 double positive in this patient, which may indicate a poor prognosis in the early time. Therefore, the patient was treated with postoperative radiotherapy. The patient continues to be followed up for prognostic evaluation, and no recurrence or metastasis occurred until now. The case has represented a full view to gaining an improved understanding of TCCRP.