J Korean Soc Radiol.  2016 May;74(5):331-334. 10.3348/jksr.2016.74.5.331.

Port Site Metastasis of Breast Cancer after Video-Assisted Thoracic Surgery for Pulmonary Metastasis of Breast Cancer: A Case Report

• Park M
• Hwang JY
• Hyun SJ
• Lee Y
• Woo JY
• Yang I
• Hong HS
• Kim HM

• KMID: 2164830
• DOI: http://doi.org/10.3348/jksr.2016.74.5.331

Abstract

We reported a case of port site metastasis in a 57-year-old patient who underwent video-assisted thoracic surgery (VATS) resection of pulmonary metastasis from breast cancer. Port site metastasis after VATS is very rare in patients with breast cancer. However, when suspicious lesions are detected near the port site in patients who have undergone VATS for pulmonary metastasis, port site metastasis should be considered in the differential diagnosis.

MeSH Terms

Breast Neoplasms*
Breast*
Diagnosis, Differential
Humans
Middle Aged
Neoplasm Metastasis*
Neoplasm Seeding
Thoracic Surgery, Video-Assisted*

Figure

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  Fig. 1 Positron emission tomography-computed tomography of a 59-year-old woman 2 years after mastectomy. Two pulmonary nodules are seen in the left lung with maximum standardized uptake value of 5.0, suggestive of metastasis (arrows). These nodules were confirmed as metastatic invasive ductal carcinoma from the breast after video-assisted thoracic surgery resection.

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  Fig. 2 Ultrasonography (US) performed 6 months after video-assisted thoracic surgery (VATS) resection for evaluation of a palpable mass in the left breast. A. Transverse US scan reveals a 2.0 × 1.8 × 1.9 cm size, circumscribed round mass in lower outer quadrant of left breast around the port insertion area. The mass shows complex cystic and solid echogenicity. Port site scar after VATS (arrow) is demonstrated as subtle linear hypoechoic tract between the mass and the skin. B. On color Doppler US, the mass shows internal vascularity.

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  Fig. 3 Follow-up ultrasonography (US), computed tomography (CT), and positron emission tomography-computed tomography (PET-CT) after video-assisted thoracic surgery resection of pulmonary metastasis of breast cancer, and histopathologic image of surgically resected specimen. A. The mass in the lower outer quadrant periphery of the left breast shows an increase in size, as compared with previous US performed 6 months earlier, measuring 3.8 × 3 × 3.4 cm. B. Contrast-enhanced CT demonstrates rim enhancing lobulated mass with central necrosis at the port site. C. PET-CT shows fluorodeoxyglucose (FDG) uptake in the periphery of the mass with maximum standardized uptake value of 5.0. An enlarged right internal mammary lymph node is also noted with increased FDG uptake. D. Photomicrograph shows prominent nuclear pleomorphism, no identifiable tubule formation, and rampant mitotic activity, indicating invasive ductal carcinoma with nuclear grade 3 and modified Bloom-Richardson histologic grade III/III (hematoxylin and eosin stain, × 200).

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