Cancer of unknown primary ultimately diagnosed as male breast cancer: A rare case report

Abstract

Cancers of unknown primary (CUP) constitute a significant diagnostic and therapeutic challenge for clinicians and a frequent cause of cancer-related mortality in Western countries. Immunohistochemistry assays are commonly used to identify the primary cancer, but fail in approximately one-third of cases. The identification of the possible origin of CUP is crucial, as it may help select the appropriate treatment options. We herein present the case of a 54-year-old male patient, who presented with lower back pain in June, 2013. Following a thorough investigation, the clinical and pathological findings could not identify the primary cancer, leading towards a misdiagnosis. Ultimately, microRNA testing of the resected spine lesion was able to identify the primary tumor as male breast cancer and allow for optimal treatment of the patient.

Cancer-of-Unknown-Primary-Origin: A SEER–Medicare Study of Patterns of Care and Outcomes among Elderly Patients in Clinical Practice

“…Patients who did not receive a full diagnostic work-up had shorter median overall survival, particularly with increasing age. The high early and overall mortality among patients who did not receive histologic confirmation suggests that these patients in general were nevertheless suffering from cancer; although without histologic confirmation, some of these individuals may have had more easily treatable cancers than CUP, another treatable diagnosis mimicking cancer on imaging, or a relapse of a pre-existing malignancy that might have been missed [ 29 , 30 , 31 ]. Given that the time to treatment was similar to the median survival time in this population, it is not surprising that a shorter median survival was observed in untreated patients, although no causal relationship can be inferred based on this study.…”

Rare axillary cancer of unknown primary originating from the breast of a 64‑year‑old male patient: A case report and literature review

“…Twelve articles published from 2008 to 2020 and reporting cases of CUP of breast cancer origin were identified (27,(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39) (Table I). The mean age of the patients was 59,23 years (range 29 to 83).…”

“…The mean age of the patients was 59,23 years (range 29 to 83). Three men were smokers (35,38,39) and two of them (35,38) referred a familiarity for gastric cancer: in a case the father, and in the other the mother was affected. In 12 cases reported the first presentation was an axillary mass; in one case the tumor was located on the anterior chest wall (29) while in another case, a vertebral painful lesion was diagnosed in the same moment of the axillary nodule (39).…”

“…Three men were smokers (35,38,39) and two of them (35,38) referred a familiarity for gastric cancer: in a case the father, and in the other the mother was affected. In 12 cases reported the first presentation was an axillary mass; in one case the tumor was located on the anterior chest wall (29) while in another case, a vertebral painful lesion was diagnosed in the same moment of the axillary nodule (39). Seven men was affected by comorbidities: four of them showed dermatologic disease such as eczema, reddish skin, dermatomyositis, and erythema (27,29,(34)(35).…”

Cancer of Unknown Primary: Challenges and Progress in Clinical Management

“…As confirmation of molecular testing performance, in a case regarding a 61-year-old female CUP patient with a suspected peritoneal or ovarian primary site, the molecular prediction by miRviews met 2 (Rosetta Genomics, Princeton, NJ, USA) pointed out a mesothelioma origin; the prediction was later confirmed by additional IHC stains, leading to a therapeutic switch from platinum/taxane to pemetrexed/platinum salts that resulted in an improvement of the patient’s survival [ 127 ]. In another report, the clinical history of a 54-year-old male CUP patient was described; in this case the 64-mi, RNA assay predicted, with high probability (90%), a breast cancer origin, later confirmed by pathologic evaluation and IHC performed on breast resected metastasis, thus allowing optimal treatment for the patient [ 147 ].…”