Metastatic extramammary Paget's disease with HER2 amplification to renal cell carcinoma: a unique presentation of cancer in cancer metastasis

Abstract

results from an acute coronary dissection of a nonatherosclerotic coronary artery. Eighty percent of spontaneous or primary coronary artery dissections occur in females with an age range between 25 and 60 years and most cases are sporadic. Most cases occur during pregnancy, pastpartum period, 6 or are related to oral contraceptive pills. 7 Although the exact pathophysiology of this rare condition remains unknown, it has been postulated that hormones, particularly progesterone, can cause weakening of the media. In addition, the stress of labour may lead to dissection of weakened vessels. 2,8 On the other hand, gender differences do exist. For example, the right coronary dissections are more common in men, while left coronary dissections are more common in females. 2,9 This leads to several reports suggesting a role for a cytokine-mediated action especially when an inflammatory cellular infiltrate is seen. But it remains uncertain whether these inflammatory changes are contributing to the dissection. 10 No inflammatory infiltrate was seen in our case.