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Xu J, Liu C, Yu C, Yu T, Fan F, Zhang X, Huang C, Chen W, Sun Z, Zhou M. Breast mass as the first sign of metastasis from rectal carcinoma: a case report and review of the literature. Front Oncol 2023; 13:1211645. [PMID: 37434982 PMCID: PMC10332164 DOI: 10.3389/fonc.2023.1211645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 06/12/2023] [Indexed: 07/13/2023] Open
Abstract
We present a case report of a 41-year-old woman who developed a left breast mass 18 months after undergoing Dixon rectal cancer surgery. The purpose of this case report is to highlight the possibility of breast metastases in patients with colorectal cancer and emphasize the importance of careful evaluation and follow-up as well as timely and accurate diagnosis and management of the metastatic disease. During the physical examination in 2021, we noted that the lower border of the mass was 9 cm from the anal verge and that it occupied approximately one-third of the intestinal lumen. A pathological biopsy revealed the mass in the patient's intestinal lumen was a rectal adenocarcinoma. The patient underwent Dixon surgery for rectal cancer and received subsequent chemotherapy. The patient had no prior history of breast-related medical conditions or a family history of breast cancer. During the current physical examination, we discovered multiple lymphadenopathies in the patient's left neck, bilateral axillae, and left inguinal region, but none elsewhere. We observed a large erythema of about 15x10 cm on the patient's left breast, with scattered hard nodes of varying sizes. Palpation of the area beyond the upper left breast revealed a mass measuring 3x3 cm. We conducted further examinations of the patient, which revealed the breast mass and lymphadenopathy on imaging. However, we did not find any other imaging that had significant diagnostic value. Based on the patient's conventional pathology and immunohistochemical findings, combined with the patient's past medical history, we strongly suspected that the patient's breast mass was of rectal origin. This was confirmed by the abdominal CT performed afterward. The patient was treated with a chemotherapy regimen consisting of irinotecan 260 mg, fluorouracil 2.25 g, and cetuximab 700 mg IV drip, which resulted in a favorable clinical response. This case illustrates that colorectal cancer can metastasize to unusual sites and underscores the importance of thorough evaluation and follow-up, particularly when symptoms are atypical. It also highlights the importance of timely and accurate diagnosis and management of metastatic disease to improve the patient's prognosis.
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Affiliation(s)
- Jiawei Xu
- Department of Breast Surgery, Jiangxi Cancer Hospital, The Second Affiliated Hospital of Nanchang Medical College, Jiangxi Clinical Research Center for Cancer, Affiliated Cancer Hospital of Nanchang University, Nanchang, Jiangxi, China
- Department of Pathology, Jiangxi Cancer Hospital, The Second Affiliated Hospital of Nanchang Medical College, Jiangxi Clinical Research Center for Cancer, Affiliated Cancer Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Chao Liu
- Department of Breast Surgery, Jiangxi Cancer Hospital, The Second Affiliated Hospital of Nanchang Medical College, Jiangxi Clinical Research Center for Cancer, Affiliated Cancer Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Chengdong Yu
- Department of Breast Surgery, Jiangxi Cancer Hospital, The Second Affiliated Hospital of Nanchang Medical College, Jiangxi Clinical Research Center for Cancer, Affiliated Cancer Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Tenghua Yu
- Department of Breast Surgery, Jiangxi Cancer Hospital, The Second Affiliated Hospital of Nanchang Medical College, Jiangxi Clinical Research Center for Cancer, Affiliated Cancer Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Fan Fan
- Department of Breast Surgery, Jiangxi Cancer Hospital, The Second Affiliated Hospital of Nanchang Medical College, Jiangxi Clinical Research Center for Cancer, Affiliated Cancer Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Xiaofang Zhang
- Department of Pathology, Jiangxi Cancer Hospital, The Second Affiliated Hospital of Nanchang Medical College, Jiangxi Clinical Research Center for Cancer, Affiliated Cancer Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Chuansheng Huang
- Department of Pathology, Jiangxi Cancer Hospital, The Second Affiliated Hospital of Nanchang Medical College, Jiangxi Clinical Research Center for Cancer, Affiliated Cancer Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Wen Chen
- Department of Breast Surgery, Jiangxi Cancer Hospital, The Second Affiliated Hospital of Nanchang Medical College, Jiangxi Clinical Research Center for Cancer, Affiliated Cancer Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Zhengkui Sun
- Department of Breast Surgery, Jiangxi Cancer Hospital, The Second Affiliated Hospital of Nanchang Medical College, Jiangxi Clinical Research Center for Cancer, Affiliated Cancer Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Meng Zhou
- Department of Breast Surgery, Jiangxi Cancer Hospital, The Second Affiliated Hospital of Nanchang Medical College, Jiangxi Clinical Research Center for Cancer, Affiliated Cancer Hospital of Nanchang University, Nanchang, Jiangxi, China
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2
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Sellers CM, Ortiz-Perez T, Dhamne S, Roark A, Gilman L. Intramammary Metastases from Extramammary Malignancies: An Update. CURRENT BREAST CANCER REPORTS 2023. [DOI: 10.1007/s12609-023-00484-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
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3
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Huayanay Espinoza JL, Mego Ramírez FN, Guerra Miller H, Huayanay Santos JL, Guelfguat M. A Spectrum of Metastases to the Breast: Radiologic-Pathologic Correlation. JOURNAL OF BREAST IMAGING 2023; 5:209-229. [PMID: 38416928 DOI: 10.1093/jbi/wbac083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Indexed: 03/01/2024]
Abstract
Metastases to the breast from non-mammary origin are rare. The majority of these lesions appear as secondary manifestations of melanoma and lymphoma, followed by lung carcinomas, gynecological carcinomas, and sarcomas. There has been a steady trend of an increase in diagnosis of intramammary metastases owing to the current advances in imaging technology. Imaging features depend on the type of primary neoplasm and route of dissemination, some of which resemble primary breast cancer and benign breast entities. There are certain imaging features that raise the level of suspicion for metastases in the correct clinical context. However, imaging manifestations of intramammary metastases do not always comply with the known classic patterns. The aim of this review is to clarify these features, emphasizing radiologic-pathologic correlation and a multidisciplinary approach, since most cases are found in patients with advanced disease.
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Affiliation(s)
| | | | - Henry Guerra Miller
- Instituto Nacional de Enfermedades Neoplásicas, Department of Pathology, Lima, Peru
| | | | - Mark Guelfguat
- Jacobi Medical Center, Department of Radiology, Bronx, NY, USA
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4
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Park SY, Park JY, Park JW, Kim WH, Park JY, Kim HJ. Unexpected hyperechoic lesions of the breast and their correlations with pathology: a pictorial essay. Ultrasonography 2022; 41:597-609. [PMID: 35462528 PMCID: PMC9262659 DOI: 10.14366/usg.21243] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 02/12/2022] [Indexed: 12/04/2022] Open
Abstract
Hyperechoic lesions of the breast encompass a wide range of conditions that are occasionally encountered during breast ultrasonography. Although typical hyperechoic lesions with a distinct fat component on imaging are well known, some hyperechoic lesions are diagnosed as unexpected pathology, making the radiology-pathology correlation difficult. Therefore, understanding the pathology of these lesions and how it correlates with imaging findings can help radiologists accurately diagnose and properly manage a range of related conditions. This article presents a pictorial review of unexpected hyperechoic benign and malignant breast lesions, with a focus on the pathological conditions that give rise to the hyperechoic pattern.
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Affiliation(s)
- Seo Young Park
- Department of Radiology, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, Korea.,Department of Radiology, Fatima Hospital, Daegu, Korea
| | - Jee Young Park
- Department of Pathology, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, Korea
| | - Ji Won Park
- Department of Radiology, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, Korea.,Department of Radiology, Chamteunteun Hospital, Daegu, Korea
| | - Won Hwa Kim
- Department of Radiology, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, Korea
| | - Ji Young Park
- Department of Pathology, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, Korea
| | - Hye Jung Kim
- Department of Radiology, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, Korea
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5
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Bannon M, Marak C, Ashraf A, Smith C, Nunley M, Guddati AK, Kaushik P. Unusual presentation of a small cell lung cancer with bilateral breast metastases: Case report and a brief review of the literature. Respir Med Case Rep 2022; 38:101693. [PMID: 35799863 PMCID: PMC9254160 DOI: 10.1016/j.rmcr.2022.101693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 06/20/2022] [Indexed: 11/29/2022] Open
Abstract
Small cell lung cancer (SCLC) is a smoker's disease and occurs almost exclusively in smokers. SCLC is a high-grade neuroendocrine tumor and commonly presents as a central tumor with bulky mediastinal adenopathy. It is notorious for causing widespread disease and paraneoplastic syndromes. The usual sites of metastasis include the liver, brain, bone, and adrenals. SCLC presenting with breast metastasis is unusual; however, there are reports of unilateral and bilateral breast metastases. SCLC with bilateral breast metastases is extremely rare, with only five previously reported cases available in the literature. We are taking this opportunity to report and add to the growing literature on the unusual presentation of a small cell lung cancer with bilateral breast metastases.
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6
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Saywon DM, Mulamira P. Cervical squamous cell carcinoma metastasis to the breast - A case report from Uganda Cancer Institute. Gynecol Oncol Rep 2021; 38:100892. [PMID: 34926772 PMCID: PMC8651791 DOI: 10.1016/j.gore.2021.100892] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 11/10/2021] [Accepted: 11/12/2021] [Indexed: 11/28/2022] Open
Abstract
Cervical squamous cell carcinoma does metastasize to the breast. Vagina exam is essential in a patient who presents with a breast mass. Immunohistochemistry is key in differentiating a primary lesion from a metastasis.
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Affiliation(s)
- Deazee M Saywon
- Department of Gynecological Oncology, Uganda Cancer Institute, Kampala, Uganda
| | - Pius Mulamira
- Gynecological Oncologist, Uganda Cancer Institute, Kampala, Uganda
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7
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Huayanay Espinoza JL, Mego Ramírez FN, Guerra Miller H, Guelfguat M. An Overview of Rare Breast Neoplasms with Radiologic-Pathologic Correlation. CURRENT BREAST CANCER REPORTS 2021. [DOI: 10.1007/s12609-021-00433-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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8
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Bilateral breast metastases as the first manifestation of an occult pancreatic neuroendocrine tumor. Radiol Case Rep 2021; 16:3807-3814. [PMID: 34745398 PMCID: PMC8551534 DOI: 10.1016/j.radcr.2021.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 09/04/2021] [Accepted: 09/04/2021] [Indexed: 11/23/2022] Open
Abstract
Breast metastases are uncommon findings compared to primary breast cancer and in particular bilateral secondary breast lesions from neuroendocrine tumor (NET)s are extremely rare with just less over 13 cases described in literature. We reported herewith the case of a 54-year-old woman who presented to our Breast Unit after noticing multiple, mobile, bilateral breast lumps. Imaging studies confirmed the presence of multiple, circumscribed, bilateral breast masses with slightly spiculated margins, classified as suspicious for malignancy (BI-RADS 4). A tru-cut biopsy was carried out on the largest lesion of each side and histopathologic and immunohistochemistry examination was consistent with metastases from pancreatic neuroendocrine tumor (PNET). Total-body CT revealed the presence of a mass located in the pancreatic body - tail with associated abdominal lymphadenopathies and multiple secondary nodules in bilateral breast and in the liver. Stage IV disease was diagnosed, patient did not undergo surgery and started LAR – octreotide therapy. Although rare, breast metastases from NETs represent an important diagnostic challenge for practitioners because of the difficulty to differentiate from a primary breast carcinoma or even from benign breast lesions. Clinicians should be aware of the possibility of bilateral breast metastases in differential diagnosis of breast lesions in order to ensure the correct diagnosis and the most appropriate management of these patients.
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9
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Abstract
Common presentation of primary gallbladder carcinoma is with abdominal pain, or it may be detected incidentally in postcholecystectomy specimen for cholelithiasis. Primary gallbladder carcinoma spreads to adjacent hepatic parenchyma and locoregional nodes. Lung is a common extra-abdominal site, with other sites being relatively rare. We report a case of primary gallbladder carcinoma, which presented with elbow swelling in the absence of locoregional nodal spread detected on whole-body F-FDG PET/contrast-enhanced CT at initial evaluation.
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10
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Economopoulou P, Chrysikopoulou A, Goula K, Papiri I, Psyrri A, Kotsantis I, Arkadopoulos N, Michalopoulos NV. Breast Metastasis from Neuroendocrine Carcinoma of the Lung: A Case Report and Review of the Literature. Case Rep Oncol 2020; 13:1281-1284. [PMID: 34191931 PMCID: PMC7649700 DOI: 10.1159/000510936] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 08/11/2020] [Indexed: 11/19/2022] Open
Abstract
Breast metastasis originating from non-mammary tumors is an uncommon event accounting for 0.5-6.6% of all breast neoplasms. The primary malignancies that reportedly metastasize to the breast most frequently are hematologic malignancies, such as leukemia and lymphoma and malignant melanoma. Breast cancer metastasis resulting from a primary lung neoplasm is significantly less commonly described in the literature. Herein, we present the unusual case of a patient with metastatic disease to the breast from a primary lung tumor.
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Affiliation(s)
- Panagiota Economopoulou
- Section of Medical Oncology, Second Department of Internal Medicine, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece
| | - Athena Chrysikopoulou
- Fourth Department of Surgery, Medical School, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece
| | - Kalliroi Goula
- Department of Pathology, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece
| | - Ilectra Papiri
- Fourth Department of Surgery, Medical School, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece
| | - Amanda Psyrri
- Section of Medical Oncology, Second Department of Internal Medicine, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece
| | - Ioannis Kotsantis
- Section of Medical Oncology, Second Department of Internal Medicine, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece
| | - Nikolaos Arkadopoulos
- Fourth Department of Surgery, Medical School, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece
| | - Nikolaos V Michalopoulos
- Fourth Department of Surgery, Medical School, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece
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11
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Medullary Thyroid Carcinoma Presenting as Metastatic Disease to the Breast. Case Rep Pathol 2020; 2020:6138409. [PMID: 32528739 PMCID: PMC7262663 DOI: 10.1155/2020/6138409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 04/19/2020] [Accepted: 05/16/2020] [Indexed: 11/17/2022] Open
Abstract
Medullary thyroid carcinoma (MTC) is a neuroendocrine tumor that is derived from C cells of the thyroid gland. It is a rare aggressive tumor, known to metastasize to lymph nodes, liver, bones, and lungs. A 41-year-old female, who presented with a breast mass, was initially diagnosed with invasive ductal carcinoma. She was also found to have a thyroid mass which was later diagnosed as MTC. On a rereview of the breast pathology, the morphologic features were strikingly similar to the MTC. Further investigation revealed that this was in fact a very rare case of MTC that had metastasized to the breast. We have identified 20 cases of MTC metastasizing to the breast in the literature that supports its occurrence as a real possibility. Albeit rare, medullary thyroid carcinoma should be considered in the differential diagnosis of a breast mass.
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12
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Choudhery S, Xiao L, Zingula S. Review of Nonmammary Metastases to the Breast: Imaging and Clinical Presentation. Curr Probl Diagn Radiol 2020; 50:495-498. [PMID: 32534793 DOI: 10.1067/j.cpradiol.2020.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 03/25/2020] [Accepted: 04/14/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVES The purpose of our study is to review the imaging findings of breast metastases from nonmammary sources at our institution and to explore the mode of initial detection of these breast metastases. METHODS In this study, we reviewed our electronic medical record and our breast imaging database for all patients who presented with nonmammary metastases to breasts between 5/1/2009 and 12/1/2019. We reviewed all available imaging data, clinical notes, and pathology reports. RESULTS Sixteen cases of nonmammary metastases to the breast were included in this study, of which there were 4 (25%) metastases from melanoma, 3 (19%) from carcinoid tumor, 2 (13%) from lung cancer, 2 (13%) from leiomyosarcoma, 1 (6%) each from lipsarcoma, renal cell carcinoma, colon cancer, neuroendocrine tumor, and adenoid cystic carcinoma. 6/8 (75%) lesions that had breast imaging were oval in shape with circumscribed or microlobulated margins on mammography and/or ultrasound. 13/16 (81%) breast metastases were asymptomatic and diagnosed on systemic staging exams. Three out of 16 (19%) nonmammary breast metastases were palpable and were diagnosed on subsequent breast imaging. CONCLUSIONS Most (25%) nonmammary breast metastases in our patient population occur from melanoma and most breast metastases (75%) are oval in shape with circumscribed or microlobulated margins. Majority (81%) of these lesions are asymptomatic and initially diagnosed on systemic staging tests, and the remaining are discovered as palpable lesions.
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Affiliation(s)
| | - Lekui Xiao
- Department of Radiology, Mayo Clinic, Rochester, MN
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13
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Kuba MG, Giess CS, Wieczorek TJ, Lester SC. Hyperechoic malignancies of the breast: Underlying pathologic features correlating with this unusual appearance on ultrasound. Breast J 2019; 26:643-652. [PMID: 31512794 DOI: 10.1111/tbj.13501] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 07/03/2019] [Accepted: 07/08/2019] [Indexed: 11/28/2022]
Abstract
Hyperechogenicity in the breast on ultrasound (US) is usually regarded as a benign feature with only rare hyperechoic malignancies reported to date. In this study, we evaluated the pathologic findings on core needle biopsy of hyperechoic lesions and investigated the histologic features in malignancies that give rise to an echogenic pattern. A total of 163 core needle biopsies (CNB) were performed for "hyperechoic" or "echogenic" lesions between 1/1/05 and 7/31/17. Lesions were classified based on the proportion of hyperechoic areas identified. We found that all lesions with a homogenous hyperechoic pattern (>90% hyperechoic) were benign (n = 17), regardless of the type of margins. Malignancies were found in 21% (7/34, six invasive carcinomas and one lymphoma) of heterogenous lesions with ≥50% hyperechoic areas (all with noncircumscribed margins) and in 31% of lesions with <50% hyperechoic areas (19/61, 14 invasive carcinomas, two lymphomas, and three metastases), including five with circumscribed margins (one invasive carcinoma, one lymphoma, and three metastases). Two major US patterns were identified in malignant lesions, those with a hypoechoic center and hyperechoic rim, corresponding to a central tumor area with dense stroma and tumor cells infiltrating adipose tissue at the periphery ("rim pattern"), and a second "dispersed pattern" with hyperechoic areas distributed throughout the lesion. Hyperechoic malignancies were found to be comprised of a complex intermixture of elements of differing echogenicity including tumor cells, adipose tissue, and fluid (in tubules, stromal clefts, or blood vessels). Our findings support the importance of radiologists specifying the echogenic pattern of hyperechoic lesions, as heterogenous lesions are associated with a higher risk of malignancy and pathologists should be alert to the associated pathologic findings.
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Affiliation(s)
- Maria G Kuba
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.,Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Catherine S Giess
- Division of Breast Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Tad J Wieczorek
- Department of Pathology, Brigham and Women's Faulkner Hospital, Boston, Massachusetts
| | - Susan C Lester
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
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14
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Magnoni F, Di Tonno C, Accardo G, Calvello M, Corso G, Sacchini V, Galimberti V, Veronesi P. Breast cancer with rare metastatic manifestation. Future Oncol 2019; 15:2437-2440. [PMID: 31339064 DOI: 10.2217/fon-2019-0263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Affiliation(s)
- Francesca Magnoni
- IEO, European Institute of Oncology, IRCCS, Division of Breast Cancer Surgery, Milan, Italy
| | - Clementina Di Tonno
- IEO, European Institute of Oncology, IRCCS, Division of Pathology, Milan, Italy
| | - Giuseppe Accardo
- IEO, European Institute of Oncology, IRCCS, Division of Breast Cancer Surgery, Milan, Italy
| | - Mariarosaria Calvello
- IEO, European Institute of Oncology, IRCCS, Division of Cancer Prevention & Genetics, Milan, Italy
| | - Giovanni Corso
- IEO, European Institute of Oncology, IRCCS, Division of Breast Cancer Surgery, Milan, Italy.,Faculty of Medicine, University of Milan, Milan, Italy
| | - Virgilio Sacchini
- IEO, European Institute of Oncology, IRCCS, Division of Breast Cancer Surgery, Milan, Italy.,Faculty of Medicine, University of Milan, Milan, Italy
| | - Viviana Galimberti
- IEO, European Institute of Oncology, IRCCS, Division of Breast Cancer Surgery, Milan, Italy
| | - Paolo Veronesi
- IEO, European Institute of Oncology, IRCCS, Division of Breast Cancer Surgery, Milan, Italy.,Faculty of Medicine, University of Milan, Milan, Italy
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15
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Kim JH, Lee JY. Malignant phyllodes tumor of the breast with liposarcomatous differentiation: A case report with imaging findings. Radiol Case Rep 2019; 14:531-534. [PMID: 30834064 PMCID: PMC6389548 DOI: 10.1016/j.radcr.2019.02.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 02/08/2019] [Indexed: 11/20/2022] Open
Abstract
Phyllodes tumors are rare neoplasms that account for 2.5% of all fibroepithelial lesions, and 10%-20% exhibit malignant transformation. Malignant transformation often occurs in the form of stroma, and usually shows fibrosarcomatous differentiation. Liposarcomatous differentiation is a rare, developed stromal component of phyllodes tumors, and little is known about their imaging findings. We present the case of a 47-year-old woman who was diagnosed with a malignant phyllodes tumor of the breast that contained liposarcomatous elements. The patient underwent wide surgical excision of the mass and has been treated with adjuvant radiation therapy.
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Affiliation(s)
- Ji Hee Kim
- Department of Radiology, Inje University, Ilsan Paik Hospital, 2240 Daehwa-dong, Ilsan Seo-gu, Goyang-si, Gyeonggi-do, Republic of Korea
| | - Ji Young Lee
- Department of Radiology, Inje University, Ilsan Paik Hospital, 2240 Daehwa-dong, Ilsan Seo-gu, Goyang-si, Gyeonggi-do, Republic of Korea
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16
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A Case Series of Breast Metastases from Different Extramammary Malignancies and Their Literature Review. Case Rep Radiol 2019; 2019:9454201. [PMID: 30729058 PMCID: PMC6341250 DOI: 10.1155/2019/9454201] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 11/21/2018] [Accepted: 12/23/2018] [Indexed: 12/19/2022] Open
Abstract
Metastasis to the breast from all other primary sites is unusual. Twelve patients were diagnosed between 2007 and 2017 at National Cancer Institute, Mexico. Solitary or multiple masses, round or oval, and hypoechoic and solid lesions with posterior acoustic shadowing were patterns commonly reported in these patients; other arrangements include diffuse involvement of the breast simulating an inflammatory carcinoma. The development of a breast metastasis is revealed, in our experience, as a negative prognostic factor. Thus, the radiologist should know about the varied appearance of metastatic breast lesions and provide radiopathological correlations when available.
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17
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Mahjoub Villard R, Thomassin Piana J, Jalaguier Coudray A. Cancers mammaires trompeurs en imagerie conventionnelle. IMAGERIE DE LA FEMME 2018. [DOI: 10.1016/j.femme.2018.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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18
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Whorms DS, Fishman MDC, Slanetz PJ. Mesenchymal Lesions of the Breast: What Radiologists Need to Know. AJR Am J Roentgenol 2018; 211:224-233. [PMID: 29792741 DOI: 10.2214/ajr.17.19020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Mesenchymal breast tumors originate from the various components of mammary stroma. The aim of this review is to discuss the clinical presentation, imaging appearance, and management of mesenchymal breast lesions. CONCLUSION Although many mesenchymal tumors exhibit characteristic findings on imaging, others show nonspecific characteristics and require tissue biopsy for diagnosis. An awareness of the clinical and imaging presentation is essential in guiding the differential diagnosis and patient management.
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Affiliation(s)
- Debra S Whorms
- 1 Harvard Medical School, 25 Shattuck St, Boston, MA 02215
| | - Michael D C Fishman
- 1 Harvard Medical School, 25 Shattuck St, Boston, MA 02215
- 2 Department of Radiology, Division of Breast Imaging, Beth Israel Deaconess Medical Center, Boston, MA
- 3 Present address: Department of Radiology, Division of Breast Imaging, Boston Medical Center, Boston, MA
| | - Priscilla J Slanetz
- 1 Harvard Medical School, 25 Shattuck St, Boston, MA 02215
- 2 Department of Radiology, Division of Breast Imaging, Beth Israel Deaconess Medical Center, Boston, MA
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19
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Famà F, Barresi V, Giuffrè G, Todaro P, Mazzei S, Vindigni A, Gioffrè-Florio M. An Unusual Presentation of Secondary Involvement of B-Cell Chronic Lymphocytic Leukemia. A Case Report. TUMORI JOURNAL 2018; 94:617-20. [DOI: 10.1177/030089160809400431] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Extramammary tumors rarely metastasize to the breast. The commonest tumors to metastasize in breast tissue are lymphoproliferative diseases, melanoma, lung cancer and gynecological malignancies. Primary breast lymphoma has been reported in the literature with a maximum percentage of about 0.5% of all breast malignancies, while secondary localizations of lymphomas in the breast are less well studied in the literature than primary ones. The authors report a rare case of a secondary localization of B-cell chronic lymphocytic leukemia to the breast in which the diagnosis was obtained by histopathology and immunohistochemistry and further confirmed by molecular data. This occurrence must be considered in the differential diagnosis of a breast lump so that the primary hematological disease can be adequately treated and the correct type of breast surgery performed.
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Affiliation(s)
- Fausto Famà
- Division of General Surgery, Department of Human Pathology, University of Messina, Italy
| | - Valeria Barresi
- Division of Diagnostic Cytopathology, Department of Human Pathology, University of Messina, Italy
| | - Giuseppe Giuffrè
- Division of Diagnostic Cytopathology, Department of Human Pathology, University of Messina, Italy
| | - Paolo Todaro
- Division of Diagnostic Cytopathology, Department of Human Pathology, University of Messina, Italy
| | - Sergio Mazzei
- Division of General Surgery, Department of Human Pathology, University of Messina, Italy
| | - Angelo Vindigni
- Division of General Surgery, Department of Human Pathology, University of Messina, Italy
| | - Maria Gioffrè-Florio
- Division of General Surgery, Department of Human Pathology, University of Messina, Italy
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20
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Metastasis of cervical cancer to breast: A case report and review of literature. Gynecol Oncol Rep 2017; 21:48-52. [PMID: 28702499 PMCID: PMC5491753 DOI: 10.1016/j.gore.2017.06.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 06/07/2017] [Accepted: 06/10/2017] [Indexed: 11/21/2022] Open
Abstract
Metastasis to the breast from an extra-mammary malignancy has been documented in literature, however cervical cancer metastasis to the breast is very rare. Thirty-eight cases of metastatic deposit to the breast from cervical cancer have been reported in literature. Though most patients present with a breast lump, it is very difficult to clinically distinguish a primary breast malignancy from a metastatic deposit. Histopathology of the tissue, aided with immune-histochemical staining pattern provides a definitive diagnosis. Our patient, a 51-year old woman presented with breast lump and history of post-menopausal bleeding. Upon further workup, the patient was diagnosed with cervical cancer. The mammogram and ultrasound of the breast showed multiple lumps within the breast. Histopathology of the breast mass showed metastatic deposit in the breast from cervical cancer. The patient was treated with radiation therapy to the cervix along with concurrent chemotherapy for local control of pain. After completion of local treatment, she started systemic chemotherapy, however she developed health-care associated pneumonia and subdural hematoma leading to deterioration in her performance status. The patient opted for hospice care and died 2 months later. In this report, we will review the presentation of the 38 cases reported in literature and the imaging and histopathologic findings of metastatic deposits to the breast. Metastasis to the breast foretells a poor prognosis. Histopathology and immuno-histochemistry are quintessential in diagnosing metastasis. All breast lumps are first primary breast cancer unless proven otherwise.
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21
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Bitencourt AGV, Gama RRM, Graziano L, Negrão EMS, Sabino SMPS, Watanabe AHU, Guatelli CS, Souza JA, Mauad EC, Marques EF. Breast metastases from extramammary malignancies: multimodality imaging aspects. Br J Radiol 2017; 90:20170197. [PMID: 28485985 DOI: 10.1259/bjr.20170197] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Breast metastases from extramammary cancers are rare and usually related to poor prognosis. The extramammary tumours most frequently exhibiting breast metastases are melanoma, lymphomas, ovarian cancer, lung and neuroendocrine tumours, and sarcomas. Owing to the lack of reliable and specific clinical or radiological signs for the diagnosis of breast metastases, a combination of techniques is needed to differentiate these lesions from primary breast carcinoma or even benign breast lesions. Multiple imaging methods may be used to evaluate these patients, including mammography, ultrasound, MRI, CT and positron emission tomography CT. Clinical and imaging manifestations are varied, depend on the form of dissemination of the disease and may mimic primary benign and malignant breast lesions. Haematologically disseminated metastases often develop as a circumscribed mass, whereas lymphatic dissemination often presents as diffuse breast oedema and skin thickening. Unlike primary carcinomas, breast metastases generally do not have spiculated margins, skin or nipple retraction. Microlobulated or indistinct margins may be present in some cases. Although calcifications are not frequently present in metastatic lesions, they occur more commonly in patients with ovarian cancer. Although rare, secondary malignant neoplasms should be considered in the differential diagnosis of breast lesions, in the appropriate clinical setting. Knowledge of the most common imaging features can help to provide the correct diagnosis and adequate therapeutic planning.
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Affiliation(s)
| | - Roberta R M Gama
- 2 Department of Cancer Prevention, Radiology Division, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - Luciana Graziano
- 1 Department of Imaging, AC Camargo Cancer Center, São Paulo, São Paulo, Brazil
| | - Erika M S Negrão
- 1 Department of Imaging, AC Camargo Cancer Center, São Paulo, São Paulo, Brazil
| | - Silvia M P S Sabino
- 2 Department of Cancer Prevention, Radiology Division, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - Anapaula H U Watanabe
- 2 Department of Cancer Prevention, Radiology Division, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - Camila S Guatelli
- 1 Department of Imaging, AC Camargo Cancer Center, São Paulo, São Paulo, Brazil
| | - Juliana A Souza
- 1 Department of Imaging, AC Camargo Cancer Center, São Paulo, São Paulo, Brazil
| | - Edmundo C Mauad
- 2 Department of Cancer Prevention, Radiology Division, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - Elvira F Marques
- 1 Department of Imaging, AC Camargo Cancer Center, São Paulo, São Paulo, Brazil
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22
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Arfi A, Clavier A, Honart JF, Ammari S, Merabet Z, Mateus C, Arfi-Rouche J. Blue Lymphangitis of the Breast after Breast Cancer: Case Report. Breast J 2016; 23:348-351. [PMID: 27914118 DOI: 10.1111/tbj.12738] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Carcinomatous lymphangitis accounts for 5% of all skin metastases, but blue lymphangitis of the breast has never been described. We report a case of blue lymphangitis of the breast in a patient 11 years after treatment for ipsilateral breast cancer that was in full remission. Breast examination and imaging showed no other abnormalities. Skin biopsy revealed a carcinomatous-pigmented infiltration corresponding to melanoma metastasis, which helped highlight a primitive right flank injury. This case report emphasizes that a full body exam should always be performed with unusual presentation of breast cancer and reiterates the indispensable place of histology before any diagnosis.
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Affiliation(s)
- Alexandra Arfi
- Service de chirurgie générale oncologique, Institut Gustave Roussy, Université Paris - Sud XI, Villejuif, France
| | - Alice Clavier
- Service de chirurgie générale oncologique, Institut Gustave Roussy, Université Paris - Sud XI, Villejuif, France
| | - Jean F Honart
- Service de chirurgie générale oncologique, Institut Gustave Roussy, Université Paris - Sud XI, Villejuif, France
| | - Samy Ammari
- Service d'imagerie diagnostique, Institut Gustave Roussy, Université Paris - Sud XI, Villejuif, France
| | - Zahira Merabet
- Service de pathologie morphologique et moléculaire, Institut Gustave Roussy, Université Paris - Sud XI, Villejuif, France
| | - Christine Mateus
- Service d'onco-dermatologie, Institut Gustave Roussy, Université Paris - Sud XI, Villejuif, France
| | - Julia Arfi-Rouche
- Service d'imagerie diagnostique, Institut Gustave Roussy, Université Paris - Sud XI, Villejuif, France
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23
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Amarti LE, Faouzi H, Salmi N, Ettahri H, Elghissassi I, Mrabti H, Errihani H. Breast metastasis from recurrent gallbladder adenocarcinoma: a case report with review of the literature. J Gastrointest Oncol 2016; 7:E77-80. [PMID: 27512606 DOI: 10.21037/jgo.2016.03.08] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Gallbladder adenocarcinoma has a poor prognostic. The leading modes of dissemination in gallbladder cancer (GBC) are lymphatic, vascular, neural, intraperitoneal, and intraductal. The most common site of dissemination is liver. Breast metastasis in GBC is an unusual site of dissemination. Only few cases have been reported in the literature. We report a rare case of solitary breast metastasis from recurrent gallbladder carcinoma in light of existing literature.
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Affiliation(s)
- Lamiae El Amarti
- Department of Medical Oncology, National Institute of Oncology, Rabat, Morocco; ; Faculty of Medicine and Pharmacy, Mohammed V University, Souissi, Rabat, Morocco
| | - Houssin Faouzi
- Faculty of Medicine and Pharmacy, Mohammed V University, Souissi, Rabat, Morocco; ; Department of surgery, National Institute of Oncology, Rabat, Morocco
| | - Nariman Salmi
- Department of Medical Oncology, National Institute of Oncology, Rabat, Morocco; ; Faculty of Medicine and Pharmacy, Mohammed V University, Souissi, Rabat, Morocco
| | - Hamza Ettahri
- Department of Medical Oncology, National Institute of Oncology, Rabat, Morocco; ; Faculty of Medicine and Pharmacy, Mohammed V University, Souissi, Rabat, Morocco
| | - Ibrahim Elghissassi
- Department of Medical Oncology, National Institute of Oncology, Rabat, Morocco; ; Faculty of Medicine and Pharmacy, Mohammed V University, Souissi, Rabat, Morocco
| | - Hind Mrabti
- Department of Medical Oncology, National Institute of Oncology, Rabat, Morocco; ; Faculty of Medicine and Pharmacy, Mohammed V University, Souissi, Rabat, Morocco
| | - Hassan Errihani
- Department of Medical Oncology, National Institute of Oncology, Rabat, Morocco; ; Faculty of Medicine and Pharmacy, Mohammed V University, Souissi, Rabat, Morocco
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24
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Franceschini G, Sanchez AM, Di Leone A, Scaldaferri A, Ferrucci M, Mulè A, Costantini M, Masetti R. Penile cancer metastasizing to the breast: a case report. J Med Case Rep 2016; 10:53. [PMID: 26961850 PMCID: PMC4785622 DOI: 10.1186/s13256-016-0829-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 02/12/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Penile cancer is a relatively uncommon cancer in developed nations. Metastatic disease is rare, but lymphatic or vascular spreading has been previously reported to the liver, lungs, bones, brain, heart and skin. CASE PRESENTATION We report a case of a 49-year-old white man with a penile squamous cell carcinoma previously treated with partial penectomy and bilateral inguinal lymph node dissection, followed by adjuvant therapy. Three years after treatment, the primitive neoplasm metastasized to the breast, presenting as a painful lump. Differentials of a secondary versus a malignant primary tumor were considered and in view of a diagnostic dilemma the lesion was excised. CONCLUSIONS This case is unusual in its site of metastatic progression as well as in its pattern of clinical presentation. Awareness of such a condition by physicians is mandatory in order to make an early diagnosis and start prompt and correct therapeutic planning.
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Affiliation(s)
- Gianluca Franceschini
- Multidisciplinary Breast Center, Università Cattolica del Sacro Cuore, Policlinico Agostino Gemelli, Largo Agostino Gemelli, 8, Roma, 00168, Italy.
| | - Alejandro Martin Sanchez
- Multidisciplinary Breast Center, Università Cattolica del Sacro Cuore, Policlinico Agostino Gemelli, Largo Agostino Gemelli, 8, Roma, 00168, Italy
| | - Alba Di Leone
- Multidisciplinary Breast Center, Università Cattolica del Sacro Cuore, Policlinico Agostino Gemelli, Largo Agostino Gemelli, 8, Roma, 00168, Italy
| | - Assunta Scaldaferri
- Multidisciplinary Breast Center, Università Cattolica del Sacro Cuore, Policlinico Agostino Gemelli, Largo Agostino Gemelli, 8, Roma, 00168, Italy
| | - Massimo Ferrucci
- Multidisciplinary Breast Center, Università Cattolica del Sacro Cuore, Policlinico Agostino Gemelli, Largo Agostino Gemelli, 8, Roma, 00168, Italy
| | - Antonio Mulè
- Multidisciplinary Breast Center, Università Cattolica del Sacro Cuore, Policlinico Agostino Gemelli, Largo Agostino Gemelli, 8, Roma, 00168, Italy
| | - Melania Costantini
- Multidisciplinary Breast Center, Università Cattolica del Sacro Cuore, Policlinico Agostino Gemelli, Largo Agostino Gemelli, 8, Roma, 00168, Italy
| | - Riccardo Masetti
- Multidisciplinary Breast Center, Università Cattolica del Sacro Cuore, Policlinico Agostino Gemelli, Largo Agostino Gemelli, 8, Roma, 00168, Italy
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25
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Jung SP, Lee HY, Bae JW, Kim HY. Medullary Thyroid Carcinoma Metastasis to the Breast and Axillary Lymph Nodes. Indian J Surg 2015; 77:329-31. [PMID: 26702242 DOI: 10.1007/s12262-015-1302-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2014] [Accepted: 06/09/2015] [Indexed: 10/23/2022] Open
Abstract
Breast metastases of medullary thyroid carcinoma (MTC) are extremely rare, and only a few cases have been reported in the literature so far. Here, we report a case of metastatic MTC to the breast and axillary lymph nodes (LN). The case illustrates that (1) metastatic MTC of the breast could be clinically and pathologically misdiagnosed as primary breast cancer, such as invasive lobular carcinoma with axillary LN involvement; (2) unlike other metastatic breast cancer patients, who have very poor prognoses, our patient survived for more than 5 years after the breast and axillary surgery; and (3) metastasis of MTC to the breast is accompanied by axillary LN metastasis, which requires thorough axillary LN dissection, as in most primary breast cancers.
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Affiliation(s)
- Seung Pil Jung
- Division of Breast and Endocrine Surgery, Department of Surgery, Korea University College of Medicine, Seoul, South Korea
| | - Hye Yoon Lee
- Division of Breast and Endocrine Surgery, Department of Surgery, Korea University College of Medicine, Seoul, South Korea
| | - Jeoung Won Bae
- Division of Breast and Endocrine Surgery, Department of Surgery, Korea University College of Medicine, Seoul, South Korea
| | - Hoon Yub Kim
- Department of Surgery, Korea University Thyroid Center, Korea University College of Medicine, Seoul, South Korea
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26
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Kalli S, Lanfranchi M, Alexander A, Makim S, Freer PE. Spectrum of Extramammary Malignant Neoplasms in the Breast With Radiologic-Pathologic Correlation. Curr Probl Diagn Radiol 2015; 45:392-401. [PMID: 26416136 DOI: 10.1067/j.cpradiol.2015.07.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 07/13/2015] [Accepted: 07/28/2015] [Indexed: 01/07/2023]
Abstract
Although primary breast cancer is the most common malignancy identified by breast imaging, extramammary malignancies may also rarely be encountered. These uncommon lesions may reflect primary neoplasms of nonmammary origin as well as secondary metastatic lesions, and include lymphoma, melanoma, neuroendocrine tumors, gastrointestinal tract malignancies, and angiosarcoma among other entities. Malignant extramammary breast lesions may be encountered during routine mammographic screening, identified during the diagnostic evaluation of a palpable breast abnormality, or may be detected incidentally during imaging of other organs of interest. As such, the radiologist should have familiarity with the appearance of these lesions. This article focuses on a review of several of the most common extramammary metastases to the breast, as well as a few lesions that may develop as either primary or secondary lesions.
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Affiliation(s)
- Sirishma Kalli
- Department of Radiology, Tufts Medical Center, Boston, MA.
| | | | | | - Shital Makim
- Department of Radiology, Tufts Medical Center, Boston, MA
| | - Phoebe E Freer
- Avon Comprehensive Breast Center, Massachusetts General Hospital, Boston, MA
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27
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Nam SY, Ko ES, Han BK, Shin S, Ko EY, Shin JH, Hahn SY. Ultrasonographic hyperechoic lesions of the breast: are they always benign? Acta Radiol 2015; 56:18-24. [PMID: 24252817 DOI: 10.1177/0284185113512482] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Most of the breast lesions show hypoechogenicity relative to fat on ultrasonography. The frequency and malignancy rate of hyperechoic lesions are not investigated in a large series. PURPOSE To evaluate the frequency and malignancy rate of hyperechoic lesions on breast sonography and to investigate sonographic characteristics that may predict malignancy in hyperechoic breast lesions. MATERIAL AND METHODS Radiologic reports of 16,416 patients who underwent breast sonography between 2007 and 2008 were searched using "hyperechoic", "echogenic" or "heterogeneous echoic" to describe lesions. Sonographic findings were evaluated according to the Breast Imaging Reporting and Data System lexicon. Clinical records including follow-up and pathologic findings were also reviewed. We calculated the frequency of hyperechoic lesions and their malignancy rate. Differences in sonographic appearances between benign and malignant lesions were also investigated. RESULTS Among the 16,416 patients, 103 (0.6%) hyperechoic lesions were identified (mean size, 1.79 cm). Of these 103 lesions, 27 (26.2%) were pathologically evaluated and five (4.9%, 4 invasive ductal carcinoma and 1 mucinous carcinoma) were confirmed as malignant. Among the 819 malignant lesions diagnosed using sonography-guided core needle biopsy, five (0.6%) were hyperechoic. In benign lesions, fat necrosis and fibroadenoma were common pathologic diagnoses. Malignant lesions were more likely to have irregular shape (P = 0.003), non-parallel orientation (P = 0.002), non-circumscribed margin (P = 0.007), and a hypoechoic area (P = 0.027) than benign lesions. All hyperechoic carcinomas were seen as suspicious masses on mammograms. CONCLUSION Hyperechoic masses are very rare and mostly benign. As an adjunct to mammography, the imaging findings reported here could help to avoid misdiagnosis for malignant hyperechoic lesion.
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Affiliation(s)
- Sang Yu Nam
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Radiology, Gil Hospital, Gachon University of Medicine and Science, Incheon, Republic of Korea
| | - Eun Sook Ko
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Boo-Kyung Han
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Suyoung Shin
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Eun Young Ko
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jung Hee Shin
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Soo Yeon Hahn
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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28
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Wang L, Wang SL, Shen HH, Niu FT, Niu Y. Breast metastasis from lung cancer: a report of two cases and literature review. Cancer Biol Med 2014; 11:208-15. [PMID: 25364582 PMCID: PMC4197421 DOI: 10.7497/j.issn.2095-3941.2014.03.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Accepted: 07/13/2014] [Indexed: 01/14/2023] Open
Abstract
Breast metastasis from extra-mammary malignancy is rare. An incidence of 0.4% to 1.3% has been reported in literature. The primary malignancies that most commonly metastasize to the breast are leukemia, lymphoma, and malignant melanoma. In this report, two cases of pulmonary metastasis to the breast were presented. A 40-year-old female manifested a right breast mass of 2-month duration. After physical examination was performed, a poorly defined mass was noted in the upper outer quadrant of the right breast. Another 49-year-old female manifested right breast mass of 5-day duration. A poorly defined mass was noted in the lower inner quadrant of the right breast. Mammography results also revealed breast cancer. The patients underwent local excision. After histological and immunohistochemical analyses were conducted, a primary lung carcinoma that metastasized to the breast was diagnosed. An accurate differentiation of metastasis to the breast from primary breast cancer is very important because the treatment and prognosis of the two differ significantly.
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Affiliation(s)
- Li Wang
- Department of Breast Cancer Pathology and Research Laboratory; Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education; Key Laboratory of Cancer Prevention and Therapy, Tianjin; Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Tianjin 30060, China
| | - Shu-Ling Wang
- Department of Breast Cancer Pathology and Research Laboratory; Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education; Key Laboratory of Cancer Prevention and Therapy, Tianjin; Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Tianjin 30060, China
| | - Hong-Hong Shen
- Department of Breast Cancer Pathology and Research Laboratory; Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education; Key Laboratory of Cancer Prevention and Therapy, Tianjin; Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Tianjin 30060, China
| | - Feng-Ting Niu
- Department of Breast Cancer Pathology and Research Laboratory; Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education; Key Laboratory of Cancer Prevention and Therapy, Tianjin; Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Tianjin 30060, China
| | - Yun Niu
- Department of Breast Cancer Pathology and Research Laboratory; Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education; Key Laboratory of Cancer Prevention and Therapy, Tianjin; Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Tianjin 30060, China
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Amzerin M, Garcia C, Stanciu C, Veys I, Awada A, Errihani H, Gombos A. Case Report: Mammary and rectal metastases from an ovarian cancer: report of two cases and review of literature. F1000Res 2014; 3:255. [PMID: 25566350 PMCID: PMC4275024 DOI: 10.12688/f1000research.2644.2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/09/2014] [Indexed: 11/20/2022] Open
Abstract
In this paper we report two interesting cases of metastatic ovarian cancer. The first case is a patient who developed rectal and breast metastases mimicking an inflammatory breast cancer. In the second case, subclinical breast and axillary lymph node metastases were revealed by PET/CT. Metastases in the breast originating from solid tumors are extremely rare. The ovarian primitive is the fourth most common origin. The occurrence of breast metastasis is associated with an advanced disease and a poor prognosis. Their incidence is increasing since they are found more often due to better imaging techniques and to better treatment that, accordingly, improve patients' survival. Thus, unusual sites of metastases are more and more reported. Indeed, some authors reported the occurrence of colorectal metastases from ovarian cancer. However, they remain much less frequent.
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Affiliation(s)
- Mounia Amzerin
- National Institute of Oncology, Université Mohammed V de Rabat, Rabat, 10100, Morocco
| | - Camilo Garcia
- Jules Bordet Institute, Université Libre de Bruxelles, Brussels, 1000, Belgium
| | - Claudia Stanciu
- Jules Bordet Institute, Université Libre de Bruxelles, Brussels, 1000, Belgium
| | - Isabelle Veys
- Jules Bordet Institute, Université Libre de Bruxelles, Brussels, 1000, Belgium
| | - Ahmad Awada
- Jules Bordet Institute, Université Libre de Bruxelles, Brussels, 1000, Belgium
| | - Hassan Errihani
- National Institute of Oncology, Université Mohammed V de Rabat, Rabat, 10100, Morocco
| | - Andrea Gombos
- Jules Bordet Institute, Université Libre de Bruxelles, Brussels, 1000, Belgium
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30
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Solitary breast metastasis from recurrent gallbladder carcinoma simulating a second primary on 18F-FDG PET/CT. Clin Nucl Med 2014; 38:e433-4. [PMID: 24096996 DOI: 10.1097/rlu.0b013e31827088c0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Gallbladder carcinoma is characterized by poor prognosis. It spreads by direct, lymphatic, vascular, neural, intraperitoneal, and intraductal routes. The most commonly involved organ is the liver followed by regional lymph nodes. Extra-abdominal metastases are comparatively rare. We present a case of solitary breast metastasis from recurrent gallbladder carcinoma mimicking a primary breast cancer in (18)F-FDG PET/CT.
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33
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Mun SH, Ko EY, Han BK, Shin JH, Kim SJ, Cho EY. Breast metastases from extramammary malignancies: typical and atypical ultrasound features. Korean J Radiol 2014; 15:20-8. [PMID: 24497788 PMCID: PMC3909857 DOI: 10.3348/kjr.2014.15.1.20] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2012] [Accepted: 07/09/2013] [Indexed: 11/26/2022] Open
Abstract
Breast metastases from extramammary malignancies are uncommon. The most common sources are lymphomas/leukemias and melanomas. Some of the less common sources include carcinomas of the lung, ovary, and stomach, and infrequently, carcinoid tumors, hypernephromas, carcinomas of the liver, tonsil, pleura, pancreas, cervix, perineum, endometrium and bladder. Breast metastases from extramammary malignancies have both hematogenous and lymphatic routes. According to their routes, there are common radiological features of metastatic diseases of the breast, but the features are not specific for metastases. Typical ultrasound (US) features of hematogenous metastases include single or multiple, round to oval shaped, well-circumscribed hypoechoic masses without spiculations, calcifications, or architectural distortion; these masses are commonly located superficially in subcutaneous tissue or immediately adjacent to the breast parenchyma that is relatively rich in blood supply. Typical US features of lymphatic breast metastases include diffusely and heterogeneously increased echogenicities in subcutaneous fat and glandular tissue and a thick trabecular pattern with secondary skin thickening, lymphedema, and lymph node enlargement. However, lesions show variable US features in some cases, and differentiation of these lesions from primary breast cancer or from benign lesions is difficult. In this review, we demonstrate various US appearances of breast metastases from extramammary malignancies as typical and atypical features, based on the results of US and other imaging studies performed at our institution. Awareness of the typical and atypical imaging features of these lesions may be helpful to diagnose metastatic lesions of the breast.
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Affiliation(s)
- Sung Hee Mun
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea. ; Department of Radiology, Catholic University of Daegu College of Medicine, Daegu 712-702, Korea
| | - Eun Young Ko
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea
| | - Boo-Kyung Han
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea
| | - Jung Hee Shin
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea
| | - Suk Jung Kim
- Department of Radiology, Inje University College of Medicine, Busan Paik Hospital, Busan 614-735, Korea
| | - Eun Yoon Cho
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea
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Larribe M, Thomassin-Piana J, Jalaguier-Coudray A. Breast cancers with round lumps: Correlations between imaging and anatomopathology. Diagn Interv Imaging 2014; 95:37-46. [DOI: 10.1016/j.diii.2013.04.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Abbas J, Wienke A, Spielmann RP, Bach AG, Surov A. Intramammary metastases: comparison of mammographic and ultrasound features. Eur J Radiol 2013; 82:1423-30. [PMID: 23743051 DOI: 10.1016/j.ejrad.2013.04.032] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Accepted: 04/28/2013] [Indexed: 11/16/2022]
Abstract
PURPOSE To describe the mammographical and ultrasound features of IM, and to compare radiological patterns of IM arising from different malignancies. MATERIALS AND METHODS A retrospective search in the statistical database of our institution from January 2000 to December 2009 revealed 51 cases of intramammary metastases from solid malignancies. Additionally, a retrospective search in the Pubmed database was performed. Publications in the time interval from 1980 to 2010 were considered. After thorough analysis, 119 articles with 229 patients were involved in the study. Therefore, together with our cases our analysis comprises 280 patients. Mammographic and ultrasound findings of different IM were analyzed. RESULTS The detected metastases showed two main radiological patterns: intramammary masses (81.5%) and architectural distortion (18.5%). Carcinomas of the stomach caused more frequently an architectural distortion, whereas other malignancies tended to present as intramammary masses. The size of the masses ranged from 2 to 104 mm. The largest lesions occurred in rhabdomyosarcoma, followed by hepatocellular carcinoma and squamous cell carcinomas of the head and neck region. The smallest lesions arose from malignancies of the thyroid gland carcinoma. Most IM showed circumscribed margins, while breast lesions in rhabdomyosarcoma were rather microlobulated. On ultrasound, IM from lung cancer were usually inhomogenously hypoechoic with circumscribed margins and showed posterior shadowing in almost 50% of the cases. Breast metastases from ovarian carcinoma had typically microlobulated margins and posterior enhancement. CONCLUSION IM can present with a broad spectrum of radiological features. Their imaging findings vary depending on the primary tumor.
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Affiliation(s)
- Jasmin Abbas
- Department of Radiology, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Straße 40, 06097 Halle (Saale), Germany.
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Arrigan M, Smyth L, Harmon M, Flynn C, Sheehy N. Imaging findings in recurrent extramedullary leukaemias. Cancer Imaging 2013; 13:26-35. [PMID: 23439108 PMCID: PMC3581869 DOI: 10.1102/1470-7330.2013.0004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Acute leukaemias are relatively common malignancies. Treatment has advanced significantly in the recent past and there has been improved patient survival. This improved initial response is leading to an increasing number of cases of relapse. Extramedullary relapse occurs in a wide variety of locations with varying presentations, imaging findings and differentials. The pathophysiology and clinical course of recurrent extramedullary myeloid and lymphocytic leukaemias are reviewed in this article. The wide variety of imaging findings associated with many important sites of recurrence and the associated differential diagnosis are discussed and illustrated.
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Affiliation(s)
- M Arrigan
- Department of Radiology, St James's Hospital, Dublin 8, Ireland.
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Moreira BL, Lima ENP, Bitencourt AGV, Dantas ER, Souza JAD, Marques EF. Metástase na mama originada de carcinoma ovariano: relato de caso e revisão da literatura. Radiol Bras 2012. [DOI: 10.1590/s0100-39842012000200013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Carcinoma primário de ovário raramente origina metástase para mama, com poucos casos descritos na literatura. Os autores relatam um caso de uma paciente com carcinoma ovariano que evoluiu com metástase para mama após cerca de oito anos do diagnóstico inicial da neoplasia e realizam revisão bibliográfica do assunto, dando ênfase aos aspectos de imagem.
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Lee JH, Kim SH, Kang BJ, Cha ES, Kim HS, Choi JJ. Metastases to the breast from extramammary malignancies−sonographic features. JOURNAL OF CLINICAL ULTRASOUND : JCU 2011; 39:248-255. [PMID: 21469153 DOI: 10.1002/jcu.20815] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2010] [Accepted: 01/21/2011] [Indexed: 05/30/2023]
Abstract
PURPOSE To evaluate the clinical and sonographic (US) features of metastatic tumors from extramammary malignancies to the breast. METHODS This study included 23 patients with pathologically proven metastases in the breast. Two radiologists retrospectively analyzed the images from US (n = 23), mammography (n = 11), and MRI (n = 5) examinations according to BIRADS. RESULTS Patients presented with a palpable mass or diffuse breast swelling (21/23) or were asymptomatic (2/23). Eighteen patients had solitary or multiple breast masses on US. The common US finding was an ovoid hypoechoic mass with a noncircumscribed margin. The final assessment categories were BIRADS 3 (probably benign finding) in 6 cases (25%) and BIRADS 4 (suspicious abnormality) in 18 cases (75%). In five patients, US displayed a diffuse infiltrative pattern without a focal lesion, which was categorized as BIRADS 4. CONCLUSIONS Metastatic tumors in the breast have a wide range of sonographic appearances, with some resembling benign lesions. Any newly developed mass in a patient with a known history of extramammary malignancy, even with a probably benign US appearance, should undergo biopsy for pathologic confirmation.
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Affiliation(s)
- Ji Hye Lee
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 505 Banpo-dong, Seocho-Gu, Seoul 137-701, Korea
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Surov A, Fiedler E, Holzhausen HJ, Ruschke K, Schmoll HJ, Spielmann RP. Metastases to the breast from non-mammary malignancies: primary tumors, prevalence, clinical signs, and radiological features. Acad Radiol 2011; 18:565-74. [PMID: 21393030 DOI: 10.1016/j.acra.2010.12.009] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2010] [Revised: 12/14/2010] [Accepted: 12/14/2010] [Indexed: 11/30/2022]
Abstract
RATIONALE AND OBJECTIVES Most secondary intramammary tumors occur as metastatic involvement from the contralateral breast. Breast metastases (BM) from nonmammary malignancies are very rare. The aims of this study were to estimate retrospectively the prevalence of BM from nonmammary malignancies and to describe their radiologic appearance. MATERIALS AND METHODS BM were identified in 51 patients, including 43 women and eight men with a median age of 61 years (range, 24-84 years). Computed tomography of the thoracic region identified 108 lesions in 38 patients. Mammography was available for 37 patients (54 lesions). Ultrasound evaluation was performed in 43 patients (71 lesions). In 24 patients (93 lesions), magnetic resonance imaging of the breast was done. Images were reviewed in consensus by two radiologists according to the Breast Imaging Reporting and Data System lexicon. RESULTS The prevalence of BM in several tumors ranged from 0.12% to 4.92%. On computed tomography, most metastases were round or oval in shape with marked or moderate enhancement. On mammography, solitary or multiple round or oval masses with circumscribed margins were the most common pattern of BM. Ten percent showed microcalcifications. On ultrasound, most BM were hypoechoic, oval or round in shape, with microlobulated or circumscribed margins, and posterior acoustic enhancement. Doppler imaging showed hypervascularity in 39% of BM. On magnetic resonance imaging, most lesions demonstrated marked homogenous contrast enhancement. Type 1 kinetic curve was seen in 18%, type 2 in 52%, and type 3 in 30%. CONCLUSIONS The radiologic features reported in this study should be taken into consideration in the differential diagnosis of breast lesions.
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Affiliation(s)
- Alexey Surov
- Department of Radiology, Martin-Luther-University Halle-Wittenberg, Germany.
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Park SB, Jeong AK, Lee JH, Paeng MH, Lee KS, Cho BJ, Kim HH. Imaging features of bilateral breast abnormalities. Clin Imaging 2011; 35:108-15. [PMID: 21377048 DOI: 10.1016/j.clinimag.2009.12.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2009] [Accepted: 12/05/2009] [Indexed: 11/30/2022]
Abstract
There are various-causes, broad-spectrum, heterogeneous groups with various biologic profiles, and imaging features of bilateral breast abnormalities. As imaging modalities continue to be developed, the ability to detect subtle or tiny abnormalities is improved in the contralateral breast of patients already diagnosed with unilateral breast disease, especially in breast cancer patients when using magnetic resonance imaging. Furthermore, some diseases involved bilateral breast, simultaneously. The purpose of this review is to describe imaging features of the bilateral breast abnormalities-common diseases and simultaneously involving diseases. In order to provide adequate treatment and to prevent misdiagnosis, a complete understanding of the imaging and clinical features of bilateral breast abnormalities of common diseases as well as those of simultaneously involving diseases is necessary.
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Affiliation(s)
- Sung Bin Park
- Department of Radiology, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine, Seoul, Korea.
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Linda A, Zuiani C, Lorenzon M, Furlan A, Londero V, Machin P, Bazzocchi M. The wide spectrum of hyperechoic lesions of the breast. Clin Radiol 2011; 66:559-65. [PMID: 21371696 DOI: 10.1016/j.crad.2010.12.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2010] [Revised: 12/06/2010] [Accepted: 12/14/2010] [Indexed: 11/30/2022]
Abstract
Although breast lesions are commonly detected because of their hypoechogenicity, some lesions may present with hyperechogenicity due to their histological components. Hyperechogenicity has been shown to be highly predictive of benignity; however, hyperechoic lesions can occasionally be malignant. This article reviews hyperechoic lesions of the breast, describes the underlying histological causes associated with hyperechogenicity, and the sonographic features useful for the differential diagnosis between benign and malignant hyperechoic lesions.
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Affiliation(s)
- A Linda
- Institute of Diagnostic Radiology, University of Udine, Azienda Ospedaliero-Universitaria Santa Maria della Misericordia, Udine, Italy.
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Ternier F, Hadjaj D, Jacquemier J. Sonographic appearance of a metastasis to the breast from a cerebellar medulloblastoma. JOURNAL OF CLINICAL ULTRASOUND : JCU 2010; 38:335-337. [PMID: 20544872 DOI: 10.1002/jcu.20698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
We present the case of a 29-year-old woman with a medulloblastoma of the cerebellum who developed a breast mass during the course of her disease. Core biopsy of the breast lesion revealed a metastatic medulloblastoma. Development of metastasis to the breast from medulloblastoma is very rare and the prognosis for such patients is poor. It is important to distinguish primary breast cancer from metastasis to the breast, because the therapeutic options as well as the prognosis are very different.
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Affiliation(s)
- Frédéric Ternier
- Department of Radiology, Institut Paoli-Calmettes, 232 Bvd Sainte Margueritte, 13009 Marseille, France
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Mehdi G, Ansari HA, Sherwani RK, Bhargava R. Small Cell Carcinoma in the Mammary Gland: Primary or Metastatic? A Diagnostic Challenge. World J Oncol 2010; 1:97-100. [PMID: 29147188 PMCID: PMC5649912 DOI: 10.4021/wjon2010.04.207w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2010] [Indexed: 11/24/2022] Open
Abstract
Metastatic tumours to the mammary gland are relatively uncommon as compared to primary breast malignancies. Such lesions can pose diagnostic dilemmas for both the clinician and the pathologist because it is often difficult to categorize the tumour as primary or secondary and to determine the site of origin. We present the case of a thirty year old female who was diagnosed with small cell neuro-endocrine carcinoma in the mammary gland, probably of pulmonary origin. The diagnostic challenges posed by such a case are highlighted.
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Affiliation(s)
- Ghazala Mehdi
- Departments of Pathology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Hena A Ansari
- Departments of Pathology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Rana K Sherwani
- Departments of Pathology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Rakesh Bhargava
- Departments of Tuberculosis and Chest Diseases, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
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Adams RF, Parulekar V, Hughes C, Kadour MJ, Talbot D. Radiologic characteristics and management of screen-detected metastatic carcinoid tumor of the breast: a case report. Clin Breast Cancer 2009; 9:189-92. [PMID: 19661045 DOI: 10.3816/cbc.2009.n.032] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Carcinoid tumors are known to metastasize to the breast, but their appearance can mimic a primary breast carcinoma, making biopsy essential in order to give the correct preoperative diagnosis. It has been suggested that core biopsy might precipitate a carcinoid crisis and should be avoided. We describe a case of screen-detected carcinoid tumor metastasis in the breast safely diagnosed by core biopsy and present the imaging findings, including magnetic resonance imaging and elastography. This case illustrates the importance of preoperative histologic diagnosis in enabling the appropriate surgical or medical management of these patients. Review of the literature also supports the policy that biopsy of nonhormonally active tumors may be safely performed.
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Affiliation(s)
- Rosie F Adams
- Breast Care Unit, Churchill Hospital, Headington, Oxford, OX3 7LJ, UK.
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Hairulfaizi H, Rohaizak M, Naqiyah I, Yahya M, Tan G, Zainuddin Z. Breast and Axillary Lymph Nodes Metastasis five years after Radical Nephrectomy for Renal Cell Carcinoma A Case Report and Review of the Literature. Libyan J Med 2009; 4:120-2. [PMID: 21483528 PMCID: PMC3066733 DOI: 10.4176/090510] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Breast is an uncommon and rare site for metastasis. Primary and secondary tumors of the breast need to be differentiated as management is different. We present a 67 year old female patient with two breast lumps and an axillary lymph node, 5 years after nephrectomy for Renal Cell Carcinoma (RCC). Mammogram report showed a dense spiculated mass at right upper outer quadrant and a retroareolar mass associated with clustered micro calcifications. Fine Needle Cytology and trucut biopsy were inconclusive. Computer Topography (CT) abdomen did not show evidence of RCC recurrence. After discussion with the patient, she underwent mastectomy with axillary clearance and the final histopathology report was consistent with metastasis from RCC. The management of this case is discussed.
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Breast mass as the initial presentation of esophageal carcinoma: a case report. CASES JOURNAL 2009; 2:7049. [PMID: 19829901 PMCID: PMC2740305 DOI: 10.4076/1757-1626-2-7049] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2009] [Accepted: 05/06/2009] [Indexed: 11/30/2022]
Abstract
Introduction Esophageal cancer is considered as a fatal malignancy. It mostly metastasizes to lung, liver, and bone while breast metastasis has been rarely reported. This is the fifth report of metastatic breast cancer from esophageal cancer, which differs from previous reported cases in terms of initial presentation with metastatic breast mass and no metastatic involvement of other organs. Case presentation We present a 35-year-old Caucasian woman who initially complained of a painful breast mass. Squamous pearls on cytologic evaluation suggested a metastatic lesion. Two months history of dysphagia was extracted through detailed interview with patient and further investigation revealed a stage IV esophageal squamous cell carcinoma. Conclusion In this case, breast lesion as an unusual presentation of esophageal carcinoma emphasizes the great role of thorough medical history taking and cytologic study in evaluating an accidentally detected breast mass. The increasing reports of breast metastasis in patients with esophageal carcinoma necessitate the careful breast examination in visits after treatment of the primary tumor.
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Youk JH, Kim EK, Kim GI, Ko KH. Unusual sonographic finding of metastatic invasive lobular carcinoma to the contralateral breast. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2008; 27:1771-1775. [PMID: 19023004 DOI: 10.7863/jum.2008.27.12.1771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Affiliation(s)
- Ji Hyun Youk
- Department of Radiology, Bundang CHA Hospital, Pochon CHA University, Seongnam, Korea
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Nofech-Mozes S, Mackenzie R, Kahn HJ, Ehrlich L, Raphael SJ. Breast metastasis by medullary thyroid carcinoma detected by FDG positron emission tomography. Ann Diagn Pathol 2008; 12:67-71. [DOI: 10.1016/j.anndiagpath.2006.08.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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