A Case of a Bilateral Inflammatory Breast Cancer: A Case Report

Cases of bilateral inflammatory breast cancer (IBC) are extremely rare. Our search criteria only found one other record of metachronous bilateral IBC (1). We present the case of a patient who was treated for IBC with neoadjuvant chemotherapy, modified radical mastectomy (MRM), and whole breast radiation. Less than 1 year later, the patient had a recurrence of IBC on the left chest wall with in the radiated field, as well as a new IBC on the contralateral side. Bilateral IBC is extremely rare. This entity can present challenges for the standard treatment of IBC with neoadjuvant chemotherapy, MRM, and whole breast radiation (2). Our case study shows the importance of scheduled routine imaging, screening with physical examination after IBC management, and good patient compliance in this aggressive disease (3).     

Parotid Gland Metastasis of Breast Cancer: Case Report and Review of the Literature

BACKGROUND: Parotid gland metastasis in breast cancer is extremely rare, and only 14 cases have been reported between 1982 and 2010. CASE REPORT: A 67-year-old female patient was diagnosed with invasive lobular carcinoma of the left breast. Although clinical staging was T1N3M1 (stage IV), the tumor experienced a complete response to chemotherapy. We therefore performed a mastectomy followed by radiotherapy, and continued administration of trastuzumab. However, 11 months later, the patient complained of a swelling in the left parotid gland. Histology following a partial parotidectomy revealed a parotid gland metastasis from the breast. CONCLUSION: Treatment with capecitabine in addition to trastuzumab, which is one of the strategies applied in HER2-positive breast cancer, was effective in our patient. Analysis of the 14 cases of parotid gland metastasis from the breast reported between 1982 and 2010 revealed that the metastasis may occur not by direct lymphatic but by hematogenous spread.     

Intracystic Carcinoma of the Male Breast: Report of a Case

We experienced a very rare case of male intracystic breast carcinoma. A 66-year-old man presented at our hospital because of a palpable mass in his right breast. The imaging diagnosis was an intracystic carcinoma with hemorrhagic fluid and two mural nodules. Modified radical mastectomy was performed under general anesthesia. The pathological examination revealed the intracystic papillary carcinoma with foci of microinvasion. The findings of power Doppler ultrasonography and dynamic magnetic resonance imaging were very useful for the differential diagnosis of our case. Received: September 11, 2000 / Accepted: March 6, 2001     

Synchronous Bilateral Breast Cancer with Paget's Disease and Invasive Ductal Carcinoma: Report of a Case

We report a case of synchronous bilateral breast cancer with Paget's disease and invasive ductal carcinoma. A 60-year-old Japanese woman presented with an 8-month history of discharge from the left nipple with eczema and itching. Mammography showed grouped fine calcification in the right breast, which was highly suggestive of right breast carcinoma with an intraductal component. Ultrasonography did not reveal any mass lesions in the bilateral breasts, and computed tomography and bone scintigraphy showed no site of distant metastasis. We performed a modified radical mastectomy for Paget's disease in the left breast and breast-conserving surgery for ductal carcinoma in the right breast. The histological diagnosis was Paget's disease in the left breast and invasive ductal carcinoma with a predominant intraductal component in the right breast. There was no metastasis in any of the 24 left axillary lymph nodes resected. We also gave her postoperative adjuvant chemoendocrine therapy, comprised of tamoxifen (20mg) and UFT (uracil/tegafur) (400mg) daily. The patient has been disease-free for 4 years since her operation.     

Malignant Adenomyoepithelioma of the Breast with Lung Metastases: Report of a Case

Adenomyoepithelioma of the breast is a rare lesion, and has a bicellular pattern of epithelial and myoepithelial cells which are regularly distributed in the tubular structures based on the histologic and ultrastructural features. It is thought to be a benign or a low-grade malignant disease. We herein describe a case of malignant adenomyoepithelioma of the breast with lung metastases in an 86-year-old woman. A primary massive tumor in the left breast grew rapidly within a short period of time. A simple mastectomy with sampling of the axillary lymph nodes was performed. The obtained lymph nodes did not include any metastatic lesions. Malignancy was evidenced by the presence of a high mitotic rate and severe nuclear atypia. Three months after the operation, radiology showed multiple lung metastases, and the patient died 2 weeks thereafter. Reviewing the literature, nine similar cases were reported, and the prognosis of malignant adenomyoepithelioma of the breast with distant metastases was very poor with the time of recurrence varying after initial treatments. Malignant adenomyoepithelioma should be followed up with careful screening for distant metastases. Received: November 16, 2000 / Accepted: May 15, 2001     

Brain Metastasis from Prostate Cancer: A Case Report

Brain metastases from prostate cancer are rare in postmortem examinations, and even rarer in clinical series. We report an unusual case of brain metastasis from prostate cancer confirmed by antemortem diagnosis in a 72-year-old man. The metastatic brain tumor was surgically resected and the patient was kept stable for more than 19 months after diagnosis of the brain metastasis.     

Intracystic Breast Carcinoma with Giant Axillary Metastasis: A Case Report

Abstract: Cystic breast disease is the most frequent cause of benign breast masses. While breast cysts are common, intracystic lesions, especially intracystic carcinomas, are rare. Furthermore, while breast carcinoma is the most common cancer in women, intracystic breast cancers are rare. Most intracystic breast carcinomas have been described as either papillary or medullary subtypes with infiltrating ductal carcinomas being much less common. The literature has shown their incidence to range from 0.3% to 7% of all breast carcinomas. We describe an interesting case of a premenopausal woman with a large cystic breast carcinoma and review the literature.     

Tamoxifen-Failed Male Breast Cancer with a High Level of Circulating Estrogen: Report of a Case

We report herein the case of a 40-year-old man with grade II invasive ductal carcinoma of the breast (pT1, pN0, M0: stage I) in whom a recurrence developed shortly after completion of a 2-year course of tamoxifen and 5-fluorouracil therapy following a mastectomy. Although the metastatic tumor was estrogen receptor-positive, hormone therapy combined with chemotherapy had no significant effect on tumor growth, and the patient died from disseminated tumors 2 years 6 months after completion of the adjuvant therapy. It is noteworthy that the circulating estradiol level increased from 18.0 to 892.3 pg/ml during the period of tumor progression and dissemination. We interpret these findings as an indication of high aromatase activity in the metastatic tumors. We suggest that extending tamoxifen treatment to 5 years or longer be recommended for the standard adjuvant hormone therapy of male breast cancer to prevent the early recurrence of hormone-responsive disease. Received: July 12, 1999 / Accepted: September 26, 2000     

乳腺癌腋窝淋巴结解剖术(附169例分析)

目的总结乳腺癌腋窝淋巴结解剖术(axillary lymph node dissection,ALND)的手术方法和经验。方法回顾性分析原发性乳腺癌行ALND的169例临床资料。结果本组163例行Ⅰ、Ⅱ平面解剖术,6例行Ⅰ～Ⅲ平面解剖术。切除标本共检出淋巴结4273枚;每例10～69枚,平均(25.28±10.23)枚。术后切口感染3例(1.78%),经引流治愈;患侧上肢水肿4例(2.37%),其中3例为切除Ⅲ平面淋巴结患者,1例为切除Ⅰ、Ⅱ平面淋巴结患者;腋窝淋巴漏1例(0.59%),为切除Ⅲ平面淋巴结病例;患侧上臂内侧及背侧皮肤麻木14例(8.28%),患侧胸肌萎缩5例(2.96%),多发生在先期诊治病例(1999年12月前)或切除Ⅲ平面淋巴结病例。结论ALND要求应用精细解剖技术,切除Ⅰ、Ⅱ平面淋巴结即可,人为扩大手术范围会增加特异性并发症发生率。     

Breast Necrosis after Chemotherapy for Recurrent Ovarian Cancer: Report of a Case and Review of the Literature

Breast necrosis is a rare event due to abundant blood supply of the breast. We present an unusual case of partial breast necrosis after chemotherapy for recurrent ovarian cancer. Necrotic tissue sloughed with conservative management and the wound was repaired surgically. We believe that this is the first case report of breast necrosis as a systemic complication of chemotherapy.     

Breast Carcinoma in Childhood and Adolescence: Case Report and Review of the Literature

Secretory breast carcinoma is a rare tumor originally described in children and adolescent women with a characteristic morphology and a controversial choice of treatment. We report an additional case of a 4-year-old girl with a breast tumor diagnosed as a secretory carcinoma without involvement of the axillary lymph nodes. The therapy consisted of simple mastectomy and low axillary dissection. She presented with a local recurrence near the surgical scar 8 months later, and a wide elliptical excision of the scar and underlying tissue was performed with subsequent radiotherapy of the surgical bed. This tumor has a relatively benign behavior and rarely metastasizes. A literature review revealed only 22 cases of breast carcinoma in childhood and adolescence. ▪     

Breast Hamartoma: a Case Report

Breast hamartoma is a benign and rare tumour consisting of glandular fat and fibrous tissue. A 36-year old woman was admitted to our clinic, complaining of a mass in her right breast since two months. Ultrasonographic and mammographic examinations revealed a 10 cm mass diagnosed as fibroadenolipoma. Total excision of the mass was performed without any complication. Histopathological examination revealed fibroadenomatous hamartoma.     

Lymphangitis carcinomatosis of the lesser omentum: A prognostic factor in gastric cancer

A series of 126 patients with gastric cancer who underwent radical gastrectomy with systemic lymph node dissection revealed 9 patients who survived for a median time of only 3 months. Of these 9 patients, 4 were classified by the UICC system as stage II and 5 as stage III, all of whom had lymphangitis carcinomatosis of the lesser omentum. These data suggest that although lymphangitis carcinomatosis of the lesser omentum is an uncommon finding, if it is present, curative surgery is impossible and an operation should therefore be limited to tumor palliation.     

Metastatic Breast Cancer Diagnosed During a Work-up for Urinary Incontinence: A Case Report

Breast cancer is the most commonly diagnosed cancer among women in the USA and the second leading cause of cancer deaths in women. Breast cancer metastases to the bladder are unusual but have been reported occasionally in the literature. The majority of the reports describe bladder metastases presenting with symptomatology or occurring in the context of disseminated disease. We present the case of an 87-year-old woman with a history of breast cancer and negative routine work-up for metastatic disease. She was referred to the urogynecology division in our institution because of complaints of urinary incontinence and urinary urgency. A urethrocystoscopy revealed suspicious bladder mucosal lesions that were biopsied. The pathology findings, when compared to the original cancer specimens, were consistent with metastatic disease. This case suggests that in patients with a history of breast cancer, even subtle urinary symptoms should be thoroughly evaluated.     

Bilateral Orbital Metastases as the Presenting Finding in a Male Patient with Breast Cancer: A Case Report and Review of the Literature

Abstract: Breast cancer in men has traditionally been thought to be substantially different from that in women. As more becomes known about this relatively rare entity, the similarities between genders become more striking than the differences. Carcinoma of the male breast is an uncommon disease occurring in less than 1% of all breast cancers. Male breast carcinoma is staged similarly to female breast cancer using the American Joint Committee Clinical Staging System. As in women, axillary nodal status is the strongest predictor of outcome. Distant metastasis to bones, soft tissue, lungs, and liver have been widely reported in men with breast cancer. This case report provides a rather rare presentation of a man with breast carcinoma with bilateral orbital metastasis as an initial clinical presentation.     

Isolated Splenic Metastasis from Colorectal Cancer: Report of a Case

The authors report a case of a patient with splenic metastasis with previous history of colorectal cancer. A 69-year-old woman underwent a left hemicolectomy for sigmoid colon cancer. The tumor was staged T3N0M0. Two years after the operation, there was an elevation of CEA and computed tomography (CT) scan revealed a mass in the spleen, considered as an isolated metastasis. The patient underwent splenectomy. Histological diagnosis confirmed a metastatic adenocarcinoma from colorectal carcinoma. Patient was alive without neoplasic recurrence 5 years after splenectomy. Generally, splenic metastasis is uncommon. However, with the case of colorectal cancers, metastasis to the spleen is particularly rare. As with splenic metastasis of all primary tumors, the literature recommends that the treatment, where possible, is surgical.     

Paradigm Shift of Staging and Treatment for Early Breast Cancer in the Sentinel Lymph Node Era

Abstract:   Lymph node status is the most reliable prognostic indicator for the clinical outcome of patients with most solid cancers. Because it is the first node draining the primary cancer, the sentinel lymph node (SLN) is most likely to harbor metastatic cancer cells. The tumor size of primary breast cancer is highly correlated with SLN metastasis. If the SLN is negative, the negative predictive value of the remaining nodal basin exceeds 95%. It appears that even using different techniques from different institutions, the successful rate to harvest the SLN is more than 95%. The false-negative rate is about 5–10% in most series. Breast cancer patients with early detection and a negative SLN have a significantly improved survival rate. The SLN data in breast cancer is so convincing that SLN information has been incorporated into the new American Joint Committee on Cancer (AJCC) classification of breast cancer. The therapeutic value of additional lymph node dissection after a positive SLN for breast cancer is still controversial. Follow-up data from breast cancer patients is somewhat limited, but available information shows that patients with negative SLNs fare much better. In summary, several important patterns of metastasis can be established based on the current SLN experience: 1) The earlier the breast cancer is found, the less the metastatic potential. 2) In most cases, breast cancer follows an orderly progression of metastasis to the SLN. 3) A small subgroup of patients may develop systemic dissemination without SLN involvement. Since metastatic cancer is usually incurable, it is important for oncologists to detect and resect an early breast cancer without delay. The challenge in the future will be to dissect these different patterns of metastasis based on molecular or genetic markers. Such information will be critical to select high-risk patients for adjuvant therapy.