Characteristics of metastasis in the breast from extramammary malignancies

Lee, Se Kyung; Kim, Wan Wook; Kim, Sung Hoon; Hur, Sung Mo; Kim, Sang-Min; Choi, Jae Hyuck; Cho, Eun Yoon; Han, Sang-oh; Hahn, Boo-Kyung; Choe, Jun-Ho; Kim, Jung-Han; Kim, Jee Soo; Lee, Jeong Eon; Nam, Seok Jin; Yang, Juhee

doi:10.1002/jso.21453

Cited by 127 publications

(153 citation statements)

References 30 publications

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“…However, in our patient, the lesion was poorly defined and skin redness was observed. Similar findings from other authors are rare (7,17,25,30). Distinguishing a breast metastasis from a primary mammary adenocarcinoma, based on mammographic findings, may be extremely difficult due to the wide range of imaging manifestations of the metastatic lesions (4,5,18).…”

Section: Histopathological and Immunohistochemical Findingssupporting

confidence: 82%

“…Twelve of these cases were classified as adenocarcinomas (5,9,12,19,(21)(22)(23)25). Additionally, 53 cases of breast metastasis from lung tumors were presented; however, no detailed histological classification was provided (7,18,(28)(29)(30). The majority of breast metastases present as palpable, rapidly growing, well-circumscribed and painless breast masses with predilection to the upper outer quadrant (2,7,17,21,22).…”

Section: Histopathological and Immunohistochemical Findingsmentioning

confidence: 99%

“…Thus, metastasis can mimic a primary malignancy or even a benign breast tumor (4,5,18). The most commonly described mammographic presentation is usually single but may sometimes present as multiple well-circumscribed lesions with smooth margins (3,18,30). Microcalcifications are very uncommon but have been reported in patients with metastatic serous ovarian papillary carcinoma (18,29,30).…”

Section: Histopathological and Immunohistochemical Findingsmentioning

confidence: 99%

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Breast metastasis from a pulmonary adenocarcinoma: Case report and review of the literature

et al. 2012

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Abstract. Breast metastasis from extra-mammary malignancy is rare. An incidence of 0.4-1.3% has been reported in the literature. The primary malignancies most commonly metastasizing to the breast are leukemia, lymphoma and malignant melanoma. We present a case of metastasis to the breast from a pulmonary adenocarcinoma, diagnosed concomitantly with the primary tumor. A 43-year-old female presented with dyspnea and a dry cough of 3 weeks' duration. A subsequent chest radiograph revealed a massive pleural effusion. Additionally, on physical examination, a poorly defined mass was noted in the upper outer quadrant of the right breast. The patient underwent bronchoscopy, simple right mastectomy and medical thoracoscopy. Following cytology, histology and immunohistochemistry, primary lung adenocarcinoma with metastasis to the breast and parietal pleura was diagnosed. Histologically, both the primary and metastatic anatomic sites demonstrated a micropapillary component, which has recently been recognized as an important prognostic factor. Although the patient received chemotherapy, she succumbed to her condition within 8 months. Accurate differentiation of metastasis from primary carcinoma is very important as the treatment and prognosis of the two differ significantly. IntroductionThe National Cancer Institute of the USA estimates that, based on current rates, 12.7% of females born today will be diagnosed with breast cancer in their lifetime (1). Although primary breast cancer is the most common malignancy of adult females, metastatic involvement of the breast is rare, with a reported frequency of 0.4-1.3% in clinical series (2-5). Despite its rarity, metastatic breast disease is an significant diagnostic clinical problem, as its treatment differs greatly from that of primary breast cancer. In 1907, Sitzentfrey was the first to publish a case of ovarian carcinoma metastatic to the breast (6). To date, a wide variety of malignancies have now been reported to metastasize to the breast and according to the literature, the most common primary tumors are melanomas and haematological malignancies (5-7). The lung is the most common cancer site in terms of incidence and mortality; however, there have only been a few published cases of pulmonary carcinomas metastasizing to the breast (8-12). Carcinomas with micropapillary components have been reported at several anatomical sites, including the breast, urinary bladder, ovary and major salivary glands (13). Micropapillary components are being increasingly recognized as prognostic predictors in lung adenocarcinomas and according to many studies, this may be a manifestation of aggressive behaviour (14,15). We report the case of a patient with breast metastasis from a pulmonary adenocarcinoma characterized by a micropapillary pattern and diagnosed in conjunction with the primary tumor. Written informed consent was obtained from the patient for publication of this case report and accompanying images. Case reportA 43-year-old, non-smoking housewife presented to the Emergency Departme...

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Section: Histopathological and Immunohistochemical Findingssupporting

confidence: 82%

Section: Histopathological and Immunohistochemical Findingsmentioning

confidence: 99%

Section: Histopathological and Immunohistochemical Findingsmentioning

confidence: 99%

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Breast metastasis from a pulmonary adenocarcinoma: Case report and review of the literature

et al. 2012

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“…The five female patients (cases 1, 3-6) shared the following characteristics: Female, loco-regionally advanced disease at initial diagnosis, metachronous breast metastasis following curative treatment and concurrent disseminated disease at other sites, similar to breast metastasis from other extramammary malignancies (10). The latency period from the initial diagnosis of NPC to the diagnosis of breast metastasis ranged between 6 and 42 months, with a median latency period of 27 months.…”

Section: Discussionmentioning

confidence: 99%

Clinicopathologic features and treatment of breast metastasis from nasopharyngeal carcinoma: A report of two cases and literature review

Xiao¹,

He²,

Xing³

et al. 2015

Oncology Letters

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Abstract. Breast metastasis is a rare pattern of distant metastasis from nasopharyngeal carcinoma (NPC) following curative treatment. The present study reported two patients with breast metastasis from NPC and reviewed four such patients reported in the literature, including the analysis of clinical profiles, pathological diagnoses, treatment strategies and outcomes. The breast is a potential metastatic site for patients with NPC following curative treatment; however, thus far, only metachronous breast metastasis has been reported. Infection with Epstein-Barr virus (EBV) was identified in the breast metastasis sites of the two patients investigated in the current study using in situ hybridization for EBV-encoded small RNAs. Patients with breast metastases from NPC consistently and simultaneously develop metastases in other sites. In addition, the two current patients had poor prognoses. Therefore, chemotherapy was the primary treatment strategy administered. A solitary breast metastasis was identified in the male patient. At the most recent follow-up 10 years subsequent to undergoing a Halsted mastectomy, the patient remained alive, however the patient is now lost to follow-up. This case indicates that patients exhibiting NPC with a solitary breast metastasis may still gain long-term survival by undergoing radical mastectomy; therefore, radical mastectomy should be considered in such patients. IntroductionAlthough breast cancer is the most common malignancy among female individuals, the breast is an uncommon site of metastasis from extramammary malignant neoplasms. In addition, metastases to the breast represent only 0.3-2.7% of all malignant mammary tumours (1). Excluding contralateral mammary tumours, the most common sources of primary tumour metastasis to the breast are, in decreasing order of frequency, melanoma, lymphoma, lung and ovarian cancer (2). Metastases from the head and neck cancer are rare, and those from nasopharyngeal carcinoma (NPC) are extremely rare (2).Diagnosis of breast metastasis from NPC is difficult, even when the patient has a medical history of another primary cancer. Experience of dealing with this clinical setting is lacking; in fact, only four documented cases have been reported in the literature thus far (3-5), and comprehensive descriptions of the biological behavior and optimal treatment of this entity are lacking. To reveal important aspects of breast metastasis from NPC, the present study reports two cases from the Sun Yat-Sen University Cancer Center (SYSUCC; Guangzhou, China) and reviews previous case reports of breast metastasis from NPC, emphasizing the clinicopathological and radiological features, diagnosis, treatment strategies, and outcomes.To the best of our knowledge, the current case study describes the only case of a male patient in this clinical setting exhibiting long-term survival after undergoing salvage treatment. In addition, this is the first study to review all available cases of breast metastasis from NPC. Case reportPatients. From the pathology files of t...

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“…Melanomas, lymphomas, leukemias, and sarcomas are the most common malignancies causing breast metastases. Infrequently, carcinomas of the lung, stomach, ovary, liver, tonsil, pleura, pancreas, cervix, perineum, endometrium, bladder, carcinoid tumors, and renal cell carcinomas can cause metastatic breast disease [3][4][5][6]. Bilateral breast metastases are very rare and are reported in few cases of ovarian carcinoma [6].…”

mentioning

confidence: 99%

Primary Rectal Adenocarcinoma Metastasizing to Bilateral Breasts – a Rare Case Demonstrated by 18 F-FDG PET/CT

Soundararajan

Arora

Das

et al. 2015

Nucl Med Mol Imaging

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A 22-year-old female presented with multiple painless bilateral breast masses for the past 2 months. On further questioning, she had hematochezia and constipation for three months. On digital rectal examination, thickening of rectal mucosa at 5 cm from the anal verge was found. On physical examination, multiple firm, non-tender, nodular lesions were found in bilateral breasts. Contrast-enhanced computed tomography (CECT) sagittal, coronal and axial images of the abdomen showed mass-like circumferential wall thickening in the rectum extending to the recto-sigmoid junction, which was suggestive of a primary malignant lesion (Fig. 1a-d, arrows). Sigmoidoscopy showed circumferential growth involving the rectum up to the rectosigmoid junction. Histopathology from the rectal lesion revealed signet ring cell adenocarcinoma. Mammography was performed and the differential diagnoses were primary breast malignancy, bilateral fibroadenoma and metastatic breast disease. 18 F-FDG PET/CT was done to determine the extent of the disease. Maximum intensity projection images of FDG PET showed linear diffuse increased FDG uptake involving the rectal region (Fig. 2a, arrow head), multiple areas of increased FDG uptake in the bilateral breast region (Fig. 2a, arrows), and patchy focal areas of increased FDG uptake in multiple dorso-lumbar vertebrae, multiple bilateral ribs, bilateral scapulae, the humerus, the pelvic bones, the left femur proximal shaft and in the left paravertebral region. Sagittal sections of fused 18 F-FDG PET/CT images (Fig. 2b) show subtle lytic changes with increased FDG uptake in multiple cervico-dorsal and lumbar vertebrae and the sternum, and Fig. 2c (arrow) shows circumferential thickening of the rectum with increased FDG uptake. Axial sections of fused PET/CT images (Figs. 2d, e) show multiple FDG-avid soft tissue density lesions involving bilateral breast parenchyma. 18 F-FDG PET/CT findings were suggestive of an active primary malignant disease involving the rectum with a metastatic disease involving extensive skeletal sites, bilateral breasts and retroperitoneal lymph nodes.A biopsy taken of bilateral breast masses showed a malignant tumor comprising of neoplastic cells in sheets with intracellular mucin and eccentrically pushed pleomorphic nuclei (signet ring cells) along with pools of extracellular mucin in hematoxylin and eosin-stained sections (Figs. 3a, b; 40X) which was consistent with metastatic signet ring cell adenocarcinoma to both breasts.Metastatic breast disease from extramammary primaries is uncommon and it constitutes 0.5 -6 % of all breast malignancies [1,2]. Melanomas, lymphomas, leukemias, and sarcomas are the most common malignancies causing breast metastases. Infrequently, carcinomas of the lung, stomach, ovary, liver, tonsil, pleura, pancreas, cervix, perineum, endometrium, bladder, carcinoid tumors, and renal cell carcinomas can cause metastatic breast disease [3][4][5][6]. Bilateral breast metastases are very rare and are reported in few cases of ovarian carcinoma [6]. Rectal aden...

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Characteristics of metastasis in the breast from extramammary malignancies

Cited by 127 publications

References 30 publications

Breast metastasis from a pulmonary adenocarcinoma: Case report and review of the literature

Breast metastasis from a pulmonary adenocarcinoma: Case report and review of the literature

Clinicopathologic features and treatment of breast metastasis from nasopharyngeal carcinoma: A report of two cases and literature review

Primary Rectal Adenocarcinoma Metastasizing to Bilateral Breasts – a Rare Case Demonstrated by 18 F-FDG PET/CT

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