Triple-negative breast cancer (TNBC) represents about 15% of all breast cancers and is usually characterized by aggressive clinical behavior and a poor prognosis. Four TNBC subgroups have been previously defined with different molecular profiles: (i) luminal androgen receptor (LAR), (ii) mesenchymal (MES), (iii) basal-like immunosuppressed (BLIS) and (iv) basal-like immune-activated (BLIA). Among these, LAR is characterized by the expression of the androgen receptor (AR), and exhibits genomic characteristics that resemble luminal breast cancers, with a still undefined prognosis and clinical behavior. Here, we report a case of a woman affected by recurring LAR TNBC, which underwent phenotypic changes throughout its natural history. After the initial diagnosis of LAR breast cancer, the patient experienced local recurrence with strong expression of the estrogen receptor. Due to this finding, she started treatment with a CDK4/6-inhibitor and an aromatase inhibitor, followed by oral vinorelbine, both with dismal outcomes. Then, she received everolimus and exemestane, which determined temporary disease stabilization. An extensive NGS analysis of tumor tissue showed PIK3CA and HER2 mutations. Our case is consistent with previous reports of LAR breast cancer and underlines the potential utility of re-biopsy and molecular testing in breast cancer (BC), especially in rare subtypes.

Background: Adrenal cortical carcinoma (ACC) is a rare and aggressive malignant tumor with an estimated prevalence of 0.5–2 cases per million people. For patients with advanced or metastatic disease, the prognosis is very poor, and death usually occurs in the first 24 months after diagnosis. Some cases of ACC with invasion of the inferior vena cava (IVC) and the right atrium (RA) have been reported. Methods: We herein report an additional case of IVC and RA involvement in ACC in a 61-year-old woman with no relevant past medical history. Results: The patient underwent heart surgery to remove neoplastic thrombi in the IVC and RA; abdominal surgery to remove the adrenal mass was performed one month later, when the patient’s clinical condition was stable. Conclusions: The histologic and immunohistochemical features, as well as the differential diagnosis, are highlighted herein.