Case report of concurrent primary malignancies of the breast and nasopharynx

Abstract

Abstract. The aim of this study was to report a case of concurrent primary malignancies of the breast and nasopharynx and discuss the potential relationship between Epstein-Barr virus (EBV) infection and breast cancer. A 39-year-old female presented with a palpable mass present for 1 year in her left breast. Immunohistochemical staining was performed and the results showed that the tumor cells were immunopositive for the estrogen receptor, progesterone receptor and p53 protein, and markedly positive for C-erb B2. In addition, 30% of the tumor cells were positive for the Ki-67 antigen. Blood test results revealed that EBV-CA-IgG was present and EBV-EA-IgG was reactivated. The patient was diagnosed with breast cancer (T1N0M0) and EBV infection. A mastectomy with axillary clearance was performed on the left breast. Histopathological examination provided evidence of invasive ductal adenocarcinoma. Further evaluation due to epistaxis following the breast surgery resulted in a diagnosis of nasopharyngeal carcinoma (T2N1M0). Histopathology showed a non-keratinizing undifferentiated carcinoma. The patient was treated with chemoradiotherapy for nasopharyngeal carcinoma. Twelve months following surgery and chemoradiotherapy the patient was assessed at the Cancer Hospital of Guangxi Medical University outpatient clinic and no evidence of relapse or metastasis was found. Thus, EBV infection may be involved in the pathogenesis of breast cancer, as observed in nasopharyngeal carcinoma. IntroductionThe mechanisms responsible for the appearance of multiple primary cancers remain unclear. Among the factors most frequently involved are genetic susceptibility, the immune system and intensive exposure to carcinogens, including chemical and biological carcinogens and radiation.Breast cancer is the most common neoplastic disease of women in the Western world. In developed countries, more than 200 cases are diagnosed annually per 100,000 women. The etiology and mechanisms of breast cancer are poorly understood. Well-known risk factors, including those that affect circulating sex hormones and genetic background can only explain approximately 50% of all breast cancer cases. Among the remaining 50% of cases, findings of numerous studies have suggested that Epstein-Barr virus (EBV) infection may be a causal factor (1-4).EBV is a ubiquitous γ herpes virus and infects 90% of the population. In the majority of individuals, the virus persists for life in the memory B-cell pool (5) with no adverse health consequences. The virus is essentially a B-lymphotropic agent and is associated with malignancies of B-cell origin, including Burkitt's lymphoma. However, epithelial cell infection clearly occurs in vivo, as EBV is also associated with malignancies of epithelial origin, such as nasopharyngeal carcinoma (NPC). In Burkitt's lymphoma and NPC, epidemiological and molecular virological data favor the role of the virus as a cofactor in tumor initiation and/or development. The involvement of EBV has been demonstrated by the findings of EBNA-1 express...

Epstein–Barr Virus Association with Breast Cancer: Evidence and Perspectives

“…Interestingly, some lymphocyte-rich types of BC are morphologically similar to NPC [ 62 , 63 ]. There are well-documented publications that have evaluated the presence of EBV infection in BC [ 18 , 64 , 65 ].…”

Association of Epstein-Barr virus with invasive breast carcinoma and its impact on well-known clinicopathologic parameters in Iranian women

“…[ 3 4 ] Reports of concurrent nasopharyngeal carcinoma and breast carcinoma further strengthen this hypothesis. [ 5 6 ]…”