Breast carcinoma metastasis to meningioma in the thoracic spine: A case report and review of the literature

Context

Systemic metastasis to a primary tumor of the central nervous system is uncommon. Breast carcinomas metastasizing to a possibly preexisting meningioma in the spine are reported very rarely.

Study design

Case report.

Findings

A 69-year-old female was referred to us with progressive gait disturbance. She had undergone a total mastectomy for carcinoma of the right breast 11 years previously. A magnetic resonance imaging of the thoracic spine showed an intra- and extradural spinal cord tumor. The patient underwent resection of the tumor via laminectomy from T2 to T4. After the operation, the patient''s neurological status improved significantly, and she was able to walk without assistance. Histological examination showed the tumor to be a fibrous-type meningioma within a metastatic breast cancer tumor. The patient underwent 40 Gy radiation treatment for local control of the tumor. However, the tumor recurred locally 7 months after the surgery. The patient died of carcinomatous pleurisy 13 months after the surgery.

Conclusion

This case illustrates that a primary meningioma in the thoracic spine can be a recipient of breast cancer metastasis, which may alter the treatment strategy.     

Neuroendocrine breast carcinoma metastatic to the liver: Report of a case and review of the literature

INTRODUCTION

Primary neuroendocrine breast carcinoma (NEBC) is a rare entity of breast cancer.

PRESENTATION OF CASE

We herein report a case of right hepatectomy for a NEBC liver metastasis.

DISCUSSION

Little is known about its evolution, bilologic behavior and optimal treatment. Its malignant potential has been addressed in few reports, with cases of metachronous metastases in diverse sites, even years following treatment of the breast primarily.

CONCLUSION

Treating this kind of cancer implies both breast and hepatic surgery.Primary neuroendocrine breast carcinoma (NEBC) is a rare entity of breast cancer. Little is known about its evolution, biologic behavior and optimal treatment. Its malignant potential has been addressed in few reports, with cases of metachronous metastases in diverse sites, even years following treatment of the breast primarily. We herein report a case of right hepatectomy for a NEBC liver metastasis.     

Metastasis of breast carcinoma to intracranial meningioma. Case report

A case of metastasis from breast carcinoma found within a cerebral meningioma is reported. Histological diagnosis of the cerebral tumor prompted radiological investigation that visualized the asymptomatic malignant systemic tumor and excluded other metastases elsewhere. The pathogenetic aspects of this exceptional occurence are discussed in the light of the relevant literature.     

乳腺原发性鳞状细胞癌1例报道

目的 乳腺原发性鳞状细胞癌病例报道及文献综述。 方法 对作者近期发现右乳腺原发性鳞状细胞癌病例进行分析。结果 增生的瘤细胞呈多角形,胞浆丰富,明显核异型,核分裂易见,细胞角化,可见明显角化珠和细胞间桥,肿瘤旁见多个癌细胞弥漫浸润,部分呈小叶癌化,符合乳腺鳞状细胞癌病理诊断。结论 乳腺原发性鳞状细胞癌是一种罕见的乳房恶性肿瘤,同其它乳腺肿瘤一样,早期发现、早期诊断、及早治疗是提高本病疗效的关键。     

Synchronous cerebral arteriovenous malformation and lung adenocarcinoma carcinoma brain metastases: A case study and literature review

Introduction

While there are numerous published cases of arteriovenous malformations (AVMs) developing in the setting of malignancy, it is extremely rare to find them concurrently associated in the brain.

阴茎转移性膀胱移行细胞癌一例报告并文献复习

目的 提高对阴茎转移性膀胱移行细胞癌的认识。方法 报告1例阴茎转移膀胱移行细胞癌患者资料，结合文献讨论其发病机理、临床特征及诊疗措施。患者，男，60岁，膀胱顶壁肿瘤行膀胱部分切除术后11个月余，病理报告为膀胱移行上皮细胞癌Ⅲ级，侵及深肌层，分期G3T3，发现阴茎海绵体硬结逐渐增大6个月余入院。结果 阴茎海绵体硬结细针穿刺活检示纤维组织中散在异型细胞及异型细胞巢，考虑为低分化癌，行阴茎全切术。术后病理报告示海绵体间质纤维中有成团的癌组织，符合膀胱移行细胞癌转移至阴茎，切缘未见癌组织，另送检耻骨前淋巴组织未见肿瘤细胞浸润。术后12d拔除导尿管。术后4周耻骨上区和双侧腹股沟区予^60Coγ射线3000cGy放射治疗，定期丝裂霉素膀胱灌注治疗和膀胱镜检查。现患者蹲式小便、排尿正常，随访16个月肿瘤无复发和转移。结论 阴茎海绵体硬结细针穿刺活检是诊断阴茎转移癌安全、有效的方法。盆腔内存在丰富、低压力、无静脉瓣的静脉丛及淋巴循环，当回流通路阻塞或压力升高时会发生逆流导致肿瘤细胞扩散或微转移，可能是阴茎转移性膀胱癌的发病机理。术后综合治疗措施可以预防肿瘤复发、提高治疗效果：     

Metastatic renal cell carcinoma presenting as gastric polyps: A case report and review of the literature

INTRODUCTIONRenal cell carcinoma (RCC) accounts for approximately 3% of adult malignancies and is responsible for over 13,000 deaths in the U.S. annually. The fatalities are largely due to distant metastasis, with lung, liver, bone and brain being most commonly affected organs. Gastric metastasis from RCC is a rare event (less than 20 cases reported in the English language literature) and usually presents as a large, solitary mass or ulcer (average size of 4.8 cm) resembling primary gastric cancer. Here we report the first case of metastatic RCC presenting as small gastric polyps.PRESENTATION OF CASEThe patient was a 60-year-old African American woman with a history of clear cell RCC (pT1bNX). She underwent esophagogastroduodenoscopy and colonoscopy 5 months after nephrectomy due to anemia. Two non-ulcerated, 0.6-cm benign-appearing polyps were found at the greater curvature of the gastric body, which were subsequently removed endoscopically. Unexpectedly, histopathologic examination of the gastric polyps revealed nested collections of vacuolated epithelioid cells in a background of delicate, arborizing vasculature, immediately beneath the congested and hyperplastic foveolar epithelium. A diagnosis of metastatic RCC was rendered after confirming the renal epithelial origin by immunohistochemical stains.DISCUSSIONGastric metastasis from RCC usually presents as a large, solitary mass or ulcer, but it can be subtle and present as multiple, small benign-appearing polyps.CONCLUSIONA careful follow up and thorough endoscopic and histopathologic examinations should be conducted in patients with a history of RCC who present with gastrointestinal manifestations.     

乳腺癌血行转移与血管生成相关因子相关性研究

目的探讨血管生成相关因子:癌基因HER2、缺氧诱导因子(HIF)和血管内皮细胞生长因子(VEGF)在乳腺癌组织中的表达及其与血行转移的相关性。方法应用免疫组织化学技术(SP法)检测51例乳腺浸润性导管癌组织中HER2、HIF-1α、VEGF蛋白的表达并随访其术后5年内远处血行转移的情况。结果51例乳腺浸润性导管癌组织中HER2、HIF-1a和VEGF表达均彼此相关。单因素分析显示44例乳腺浸润性导管癌中HER2、VEGF、淋巴结转移和临床肿瘤分期与癌的远处血行转移相关,HIF-1α表达与远处血行转移不相关(P>0.05)。23例淋巴结阴性乳腺癌中,仅VEGF表达与其远处血行转移密切相关(P<0.05)。结论乳腺浸润性导管癌组织中HER2可能通过HIF-1α途径调节VEGF蛋白的表达,参与乳腺癌血管的生成。VEGF表达可作为术后预测血行转移的指标之一,HER2过度表达和HIF-1α表达不能预测远处血行转移。     

Renal carcinoma relapse presenting as a peripheral nerve sheath tumor: A case report and brief review of the literature

We report a rare case of renal carcinoma metastasis involving a lumbar nerve root. Metastases to nerve roots are rare occurrences, and to our knowledge, only six cases have been reported so far in the literature. The patient in this report presented with weakness in the right lower limb and intractable pain irradiating along the L5 dermatome. MRI findings revealed a right-sided L5 nerve root mass, suggestive of a schwannoma, involving the spinal ganglion and its extraforaminal region. Complete macroscopic resection of this mass was performed, and histopathologic analysis confirmed the lesion to be a metastasis of a renal clear cell carcinoma. Local radiotherapy was given and tyrosine kinase inhibitors administered. At 5 months, the patient was pain-free and his right limb weakness had completely resolved. A tumoral recurrence could be observed on the control MRI 5 months after surgery. This report presents the first case of a patient with a renal clear cell carcinoma metastasis to a L5 nerve root, as well as a brief review of previous cases of metastases to peripheral nerve roots.     

Adenoid cystic carcinoma of the breast: Report of a case

Adenoid cystic carcinoma of the breast is an uncommon form of cancer, and only a few articles have described the cytological findings of this disease. We report herein the case of a 48-year-old woman who presented with a breast mass beneath the nipple, the aspirate from which consisted of globules of mucous balls surrounded by epithelial cells with scant cytoplasm and hyperchromatic nuclei. Microscopically, the tumor was formed by myoepithelial cells and glandular epithelial cells in a biphasic pattern. Immunohistochemical study revealed positivity for smooth muscle actin. A left total mastectomy with axillary lymph node dissection was performed. None of the 22 axillary lymph nodes contained metastases, and the patient remains well and free from recurrence 29 months after her operation. This case report provides some information about the cytological diagnosis and the accuracy of fine-needle aspiration, which must be considered despite the rarity of this disease. Received: June 24, 1999 / Accepted: January 7, 2000     

A perplexing presentation of a breast carcinoma: a case report

Breast cancer is a devastating disease for women. In this paper, we present a breast carcinoma presenting in a bizarre location. It was initially presumed that the patient had skin cancer, but the lesion turned out to be breast cancer presenting as a superficial mass on the skin of the breast.     

乳腺癌淋巴结转移与癌组织中白细胞介素-6及受体的关系

目的　研究乳腺癌淋巴结转移与活体癌组织中白细胞介素 6(IL 6)及白细胞介素 6受体 (IL 6R)表达的关系。方法　应用病理学诊断方法检查腋淋巴结有无癌细胞转移 ,采用逆转录 聚合酶链反应 (RT PCR)的方法检测乳腺癌组织IL 6、IL 6R的mRNA表达。结果　IL 6组中 ,有腋淋巴结转移的癌组织中IL 6表达率为 47.619% (10 /2 1) ,无转移的为 82 .979% (3 9/4 7) ,差异有非常显著性 (χ2 =9.0 13 ,P <0 .0 1) ;IL 6R组中 ,有淋巴结转移的IL 6R表达率为 3 8.0 95 % (8/2 1) ,无转移的为 89.3 62 % (4 2 /4 7) ,差异有非常显著性 (χ2 =19.60 ,P <0 .0 0 1)。结论　乳腺癌组织中的IL 6及IL 6R表达与乳腺癌患者的淋巴结转移及预后有关     

Juvenile fibroadenoma of the breast: Treatment and literature review

It is uncommon to find palpable breast masses in young patients. Generally, such masses are benign. Juvenile fibroadenoma is the most frequent benign tumour of the breast. The present report describes a case involving a 17-year-old girl with unilateral right breast hypertrophy, for whom resection and breast reduction was effectively achieved.Resection was combined with an aesthetically pleasing outcome through breast reduction, via a wise pattern of reduction with a superior pedicle.While young patients rarely present with breast masses, the consideration of fibroadenoma in these cases is always warranted. The disconcerting appearance of the breasts for adolescents afflicted by such benign masses underscores the importance of achieving aesthetically optimal outcomes and attaining adequate tumour resection for diagnostic purposes through pathological specimens. In the present case, the young patient underwent a procedure that fulfilled both of these valuable goals through careful pre-operative planning, pedicle selection and skin resection patterns.     

Metastasis from renal cell carcinoma to thyroid presenting as rapidly growing neck mass

INTRODUCTION

Renal cell carcinoma (RCC) is commonly known as the “internist''s tumor” because of its unpredictable behavior. Metastasis to the thyroid gland is rarely found in clinical practice.

PRESENTATION OF CASE

We report a rare case of non-thyroid malignancies NTM from renal cell carcinoma 1.5 years after radical nephrectomy in a 58-year-old man with a rapidly growing neck mass.

DISCUSSION

Malignant melanoma, breast carcinoma, lung, and skin cancer are the most common sources of non-thyroid malignancies (NTM). Although metastases of NTMs to the thyroid gland are uncommon in clinical practice, it should be considered in patients with a history of prior malignancy and a new thyroid mass.

CONCLUSION

Isolated thyroid metastasis should be considered in patients with a previous history of cancer and newly developing thyroid mass.     

乳腺癌组织黏着斑激酶、血管内皮生长因子-C表达与淋巴转移的关系

目的研究黏着斑激酶（FAK）和血管内皮生长因子-C（VEGF-C）在乳腺癌组织中的表达，探讨其与肿瘤淋巴转移的关系及两者的相关性。方法应用免疫组织化学SP法检测92例乳腺癌组织和30例乳腺良性病变组织中FAK、VEGF-C的表达情况。结果92例乳腺癌组织中FAK和VEGF-C的阳性表达率分别为69．6％和46．7％，与良性对照组比较，差异有统计学意义（P〈0．01）；FAK的阳性表达与乳腺癌肿瘤大小、腋窝淋巴结转移、临床分期星正相关（P〈0.01），VEGF-C的表达与乳腺癌腋窝淋巴结转移、临床分期呈正相关（P〈0．05）；乳腺癌组织FAK和VEGF—C的表达呈正相关（P〈0．01，列联系数C≈0．3952）。结论FAK和VEGF-C蛋白的表达与乳腺癌淋巴转移密切相关，FAK可能通过上调VEGF-C的表达，增强其淋巴管生成作用，进而促使乳腺癌细胞的淋巴转移。     

Congestive heart failure mimicking inflammatory breast carcinoma: a case report and review of the literature

Abstract: Inflammatory breast cancer is a rare but highly malignant form of breast cancer. Biopsy and histologic examination usually confirm the diagnosis. There are rare reports of difficulties in differentiating this particular type of breast malignancy from congestive heart failure (CHF). This difficulty arises when CHF is associated with unilateral breast edema and skin thickening. However, inflammatory breast carcinoma has distinctive histologic and microscopic characteristics allowing the establishment of a proper diagnosis. We report the case of a 65-year-old woman with CHF associated with unilateral breast edema and skin thickening simulating inflammatory breast carcinoma on mammography.     

Mammographic breast density and the risk of breast cancer: A systematic review and meta-analysis

ObjectivesMammographic density is a well-defined risk factor for breast cancer and having extremely dense breast tissue is associated with a one-to six-fold increased risk of breast cancer. However, it is questioned whether this increased risk estimate is applicable to current breast density classification methods. Therefore, the aim of this study was to further investigate and clarify the association between mammographic density and breast cancer risk based on current literature.MethodsMedline, Embase and Web of Science were systematically searched for articles published since 2013, that used BI-RADS lexicon 5th edition and incorporated data on digital mammography. Crude and maximally confounder-adjusted data were pooled in odds ratios (ORs) using random-effects models. Heterogeneity regarding breast cancer risks were investigated using I² statistic, stratified and sensitivity analyses.ResultsNine observational studies were included. Having extremely dense breast tissue (BI-RADS density D) resulted in a 2.11-fold (95% CI 1.84–2.42) increased breast cancer risk compared to having scattered dense breast tissue (BI-RADS density B). Sensitivity analysis showed that when only using data that had adjusted for age and BMI, the breast cancer risk was 1.83-fold (95% CI 1.52–2.21) increased. Both results were statistically significant and homogenous.ConclusionsMammographic breast density BI-RADS D is associated with an approximately two-fold increased risk of breast cancer compared to having BI-RADS density B in general population women. This is a novel and lower risk estimate compared to previously reported and might be explained due to the use of digital mammography and BI-RADS lexicon 5th edition.     

Metastasis of breast carcinoma to intracranial meningioma. Case report and review of the literature.

A case of metastasizing breast carcinoma to an intracranial meningioma is presented. The pathogenesis and principles of diagnosis of this rare occurrence are discussed in light of the data reported from the literature.