J Breast Cancer.  2012 Jun;15(2):244-247. 10.4048/jbc.2012.15.2.244.

Breast Metastasis from Renal Cell Carcinoma: Rare Initial Presentation of Disease Recurrence after 5 Years

• Mahrous M
• Al Morsy W
• Al-Hujaily A
• AL-Sulimani S

• KMID: 2242197
• DOI: http://doi.org/10.4048/jbc.2012.15.2.244

Abstract

Metastasis to the breast from extra-mammary tumors is rare with only a few sporadic cases reported. We present a 58-year-old female patient diagnosed with renal cell carcinoma. Five years ago she had a radical nephrectomy and was free of disease, then discovered solitary breast mass following self-examination. The patient presented to the breast clinic for evaluation whereupon the breast mass was identified on physical and radiological examinations. Fine needle aspiration was diagnostic of metastatic renal cell carcinoma and subsequent imaging studies demonstrated multiple pulmonary deposits and recurrent renal mass in the tumor bed of the diseased site. In a multidisciplinary clinic, the patient was elected for excision biopsy followed by systemic tyrosine kinase inhibitor therapy. Six months later she had brain metastasis and received whole brain irradiation followed by palliative therapy. We are presenting this rare case with the aim of increasing awareness of breast secondaries.

Keyword

Breast neoplasms; Breast tumors; Neoplasm metastasis; Renal cell carcinoma

MeSH Terms

Biopsy
Biopsy, Fine-Needle
Brain
Breast
Breast Neoplasms
Carcinoma, Renal Cell
Female
Humans
Middle Aged
Neoplasm Metastasis
Nephrectomy
Palliative Care
Protein-Tyrosine Kinases
Recurrence
Self-Examination
Protein-Tyrosine Kinases

Figure

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  Figure 1 Imaging finding mediolateral (A) and craniocaudal (B) views of a mammogram which showed left breast well circumscribed high-density mass (arrows) with no microclassifications.

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  Figure 2 Fine needle aspiration from left breast mass which was showing tumor cells with atypical nuclei and abundant cytoplasm with vacuolation and granularity (Diff-Quik stain, ×400).

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  Figure 3 Contrast enhanced axial computed tomography image of the chest (mediastinal window) showed heterogeneously enhanced left breast mass (arrows) and solitary right peripherally located pulmonary.

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  Figure 4 Contrast enhanced axial computed tomography image of the chest (lung window) showed tow peripherally located left pulmonary deposits (arrows).

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  Figure 5 Contrast enhanced axial computed tomography image of the abdomen showed heterogeneously enhanced mass (tumor) in the left renal bed (arrow) with invasion to left psoas muscle.

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  Figure 6 Contrast enhanced axial computed tomography image of brain showed right cerebellar lesion (arrow) of thick irregular peripheral enhancement and central necrosis with surrounding edema.

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  Figure 7 Photomicrograph showing brain tissue with metastatic clear cell carcinoma (H&E stain, ×10).

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