[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-411203-105":59,"doc-detail-411203-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","fibromatosis-like-metaplastic-carcinoma-with-aggressive-metastasis-and-a-tert-promoter-mutation-a-case-report-and-literature-review","Fibromatosis-like metaplastic carcinoma with aggressive metastasis and a TERT promoter mutation - a case report and literature review","","Fibromatosis-like metaplastic carcinoma (FLMCa) is a rare, typically indolent subtype of triple-negative breast cancer. A case report describes an exceptional patient with an aggressive course that challenges the usual view of limited metastatic potential. Diagnosis was confirmed by histopathology and immunohistochemistry, and Sanger sequencing identified a TERT promoter C228T mutation. Despite surgery, radiotherapy, and multiple chemotherapy lines, lung metastasis occurred at 5 months and bone metastasis at 15 months post-operation, supporting the need for vigilant follow-up and molecular risk reassessment.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/fibromatosis-like-metaplastic-carcinoma-with-aggressive-metastasis-and-a-tert-promoter-mutation-a-case-report-and-literature-review/411203/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/fibromatosis-like-metaplastic-carcinoma-with-aggressive-metastasis-and-a-tert-promoter-mutation-a-case-report-and-literature-review/411203.png","ImageObject",300,407,{"name":92,"@type":93},"Nguyễn Văn Học","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-06","2026-09-28",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What diagnostic methods were used to confirm fibromatosis-like metaplastic carcinoma?","Question",{"text":113,"@type":114},"The diagnosis was confirmed via histopathology and immunohistochemistry, supported by further pathological and IHC findings after surgery.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"Which genetic alteration was identified, and why is it important?",{"text":118,"@type":114},"Sanger sequencing revealed a C228T mutation in the TERT promoter region. The report suggests this mutation may contribute to the aggressive phenotype.",{"name":120,"@type":111,"acceptedAnswer":121},"What treatment was given, and what metastatic timeline was observed?",{"text":122,"@type":114},"The patient underwent surgery, radiotherapy, and multiple lines of chemotherapy. Lung metastasis developed 5 months after surgery, and bone metastasis appeared at 15 months.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},411203,1791062912,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":34,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},1374402739827,"https://ap-avatar.wpscdn.com/avatar/14000c97e7351f1a627?x-image-process=image/resize,m_fixed,w_180,h_180&k=1787885694763230660","OPEN ACCESS  \nEDITED BY  \nHafiz Shahbaz Zahoor,  \nQuaid-i-Azam Medical College, Bahawalpur, Pakistan  \nREVIEWED BY  \nShuhei Suzuki,  \nYamagata Prefectural Shinjo Hospital, Japan Muhammad Abdullah Masood,  \nQuaid-i-Azam Medical College, Bahawalpur, Pakistan  \n*CORRESPONDENCE  \nLei Li  \n [lilei@mail.jnmc.edu.cn](lilei@mail.jnmc.edu.cn)  \nRECEIVED 10 October 2025  \nREVISED 22 November 2025  \nACCEPTED 26 November 2025  \nPUBLISHED 18 December 2025  \nCITATION  \nChen J, Li Y, Bing X, Wang T, Wang W and Li L (2025) Fibromatosis-like metaplastic carcinoma with aggressive metastasis and a TERT promoter mutation: a case report and literature review.  \nFront. Med. 12:1722451 .  \ndoi: 10.3389/fmed.2025.1722451  \nCOPYRIGHT  \n© 2025 Chen, Li, Bing, Wang, Wang and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.  \nTYPE Case Report  \nPUBLISHED 18 December 2025 DOI 10.3389/fmed.2025.1722451  \nFibromatosis-like metaplastic carcinoma with aggressive metastasis and a TERT promoter mutation: a case report and literature review  \nJie Chen 1, Yan Li 2, Xue Bing 2, Ting Wang 2, Wei Wang 2 and Lei Li 2*  \n1Jining Medical University, Jining, Shandong, China, 2Department of Pathology, Affiliated Hospital of Jining Medical University, Jining, Shandong, China  \nBackground: Fibromatosis-like metaplastic carcinoma (FLMCa) is a rare, typically indolent subtype of triple-negative breast cancer. This report presentsan exceptional case of FLMCa with an aggressive clinical course, challenging the conventional understanding of its low metastatic potential.  \nMethods: A 57-year-old woman presented with a left breast mass. The diagnosis was confirmed via histopathology and immunohistochemistry. Sanger sequencing was used to investigate potential genetic drivers.  \nResults: Pathological examination confirmed FLMCa, characterized by bland spindle cells and a triple-negative immunophenotype. A genetic analysis revealed a C228T mutation in the telomerase reverse transcriptase (TERT) promoter region. Despite multimodal therapy, including surgery, radiotherapy, and multiple lines of chemotherapy, the patient developed lung metastasis at 5 months and bone metastasis at 15 months post-surgery.  \nConclusion: This case highlights that a subset of FLMCa may exhibit unexpectedly aggressive behavior and resistance to conventional therapy. The presence of a TERT promoter mutation suggests a potential molecular mechanism for this virulence. Our findings advocate for a re-evaluation of risk stratification in FLMCa and underscore the critical need for vigilant follow-up and molecular profiling to guide future targeted therapy strategies.  \nKEYWORDS  \nfibromatosis-like metaplastic carcinoma, breast cancer, TERT promoter mutation, metastasis, case report  \n1 Introduction  \nMetaplastic breast carcinoma (MBC) is a rare and aggressive group of malignancies, accounting for less than 0.5% of all breast cancers. Fibromatosis-like metaplastic carcinoma (FLMCa) is an exceptionally rare subtype of MBC, histologically characterized by a predominant proliferation of bland spindle cells that mimic benign fibrous lesions, often posing a significant diagnostic challenge ( 1). Historically, FLMCa has been regarded as having low potential for lymph node involvement and distant metastasis (2, 3). However, we present a case that profoundly challenges the textbook indolent narrative, documenting rapid, sequential distant metastases despite aggressive treatment in a patient with FLMCa, and we  \nFrontiers in Medicine 01 [frontiersin.org](frontiersin.org)  \nidentify a TERT promoter mutation as a potential con","cbCaijT9tMuAgL5D","https://ap.wps.com/l/cbCaijT9tMuAgL5D","pdf",3979487,"English","# Background\n# Methods\n# Results\n# Conclusion\n# Introduction\n# Case report","[{\"question\":\"What diagnostic methods were used to confirm fibromatosis-like metaplastic carcinoma?\",\"answer\":\"The diagnosis was confirmed via histopathology and immunohistochemistry, supported by further pathological and IHC findings after surgery.\"},{\"question\":\"Which genetic alteration was identified, and why is it important?\",\"answer\":\"Sanger sequencing revealed a C228T mutation in the TERT promoter region. The report suggests this mutation may contribute to the aggressive phenotype.\"},{\"question\":\"What treatment was given, and what metastatic timeline was observed?\",\"answer\":\"The patient underwent surgery, radiotherapy, and multiple lines of chemotherapy. Lung metastasis developed 5 months after surgery, and bone metastasis appeared at 15 months.\"}]","Fibromatosis-like metaplastic carcinoma with aggressive metastasis and a TERT promoter mutation - a case report and literature review | PDF",1790587791,18]