A case of contralateral inguinal lymph node metastases from breast cancer

Abstract

Background Breast cancer is well known to tends to invade through the lymphatic chains mainly to the axillary and subclavian nodes or occasionally to the internal mammary nodes. However, inguinal lymph node metastasis from breast cancer is extremely rare. Case presentation We have experienced a case of an 82-year-old woman showing left inguinal lymph node metastases from right breast cancer. Previously, she had received five times abdominal operations and left artificial bone head replacement for metamorphous hip-joint disease. Although the metastases were firstly detected 46 months after the breast surgery, they had already existed at the time of the breast operation, which was retrospectively re-evaluated by CT examination. The progression pattern of inguinal lymph node metastases had much correlated with that of the breast cancer. She underwent inguinal lymph node dissections. Pathological findings revealed them being compatible with breast cancer origin. Conclusions This is the sixth case having been reported in English literature. Besides, this is the first case showing the contralateral spread to the primary breast cancer. One of the causes of this complex metastatic pattern is thought be ascribed to the previously performed prolific abdominal operations.

Inguinal lymph node metastasis in treated breast cancer: an extremely rare presentation and review of literature

“…The metastatic site was ipsilateral to the primary and the presentation was pain and swelling. Except for one case,12 all the other documented cases presented with ipsilateral inguinal metastasis. Also, the presenting complaints were predominantly lower limb swelling and pain.…”

“…Also, the presenting complaints were predominantly lower limb swelling and pain. Inguinal metastasis was present at the time of diagnosis of primary disease in four cases 10 12 13. In the rest, metastasis happened after 2 years11 and 6 years9 of treatment completion.…”

“…Metastasis to inguinal lymph nodes from breast cancer is extremely rare. So far, only six cases have been documented in the English scientific literature 9–13…”

“…It may be through the subdermal lymphatics of the skin or retrograde pathway through submuscular fascia 13 14. The other possible reason could be an alteration of the physiological lymphatic channel through interventions such as breast surgery, radiotherapy and abdominal surgery 12 14 15. The presence of ectopic breast tissue in the vulva may also be an aetiology of inguinal metastasis 16 17…”

Intensity modulated radiotherapy and targeted therapy for late nonregional para-aortic lymph node metastasis from HER2 positive breast carcinoma

“…Breast cancer (BC) is well known to metastasize to the entire organs by hematological spread to such as the bone, lung, liver, and the brain. It also tends to invade through the lymphatic chains mainly to the axillary nodes or occasionally to the internal mammary nodes [1]. Regional lymph nodes of the breast include the ipsilateral axillary lymph node, ipsilateral internal breast lymph node, and ipsilateral supraclavicular lymph node, which are defined by the National Comprehensive Cancer Network [2].…”