Cancer Res Treat.  2014 Apr;46(2):200-203.

Intra-tumoral Metastatic Double Primary Carcinoma: Synchronous Metastatic Tumor in Lung from Breast and Thyroid Carcinoma

• Park LC
• Jeong JY
• Ji JH
• Park S
• Ahn JS
• Im YH
• Park YH

Abstract

Cases of phenotypic heterogeneity of cells within tumors have recently been reported. Here, we report on a patient with characteristic intra-tumor double primary metastases in the lung. This patient was a 40-year-old Korean woman who had been diagnosed with breast cancer (T1N0M0, estrogen receptor/progesterone receptor/HER2 +/+/+) and papillary thyroid cancer three years prior and underwent a complete surgical resection followed by appropriate adjuvant treatment with radiation, hormone, and radioactive iodine. She was recently admitted for newly developed pulmonary nodules. Metastasectomy through video-assisted thoracoscopic surgery revealed recurrent double primary cancer with two different components (metastatic ductal carcinomas from the breast and metastatic papillary carcinomas from the thyroid gland) in each pulmonary nodule in the right upper lobe and right middle lobe. To the best of our knowledge, this is the first report of simultaneous recurrent double metastasis in one organ from different primary origins.

Keyword

Double primary tumor; Neoplasm metastasis; Intra-tumoral heterogeneity

MeSH Terms

Adult
Breast Neoplasms
Breast*
Carcinoma, Ductal
Carcinoma, Papillary
Estrogens
Female
Humans
Iodine
Lung*
Metastasectomy
Neoplasm Metastasis
Population Characteristics
Thoracic Surgery, Video-Assisted
Thyroid Gland
Thyroid Neoplasms*
Estrogens
Iodine

Figure

• 

  Fig. 1 Chest non-contrast computed tomography (CT) scan. CT scans were obtained using a non-contrast helical CT scan protocol. Three small, well-defined nodules were found in the right upper and middle lobes of the lung, suggesting pulmonary metastases.

• 

  Fig. 2 Pathologic findings in the right middle lobe of the lung. (A) Ductal carcinoma and papillary carcinoma (H&E staining, ×100). (B) Papillary carcinoma (H&E staining, ×400). (C) Ductal carcinoma (H&E staining, ×400). (D) Thyroid transcription factor-1 immunohistochemistry (IHC) stain (uptake only in papillary carcinoma; yellow circular line) (×100). (E) Estrogen receptor IHC stain (uptake only in ductal carcinoma; yellow circular line) (×100).

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