J Breast Cancer.  2012 Sep;15(3):356-358. 10.4048/jbc.2012.15.3.356.

An Unusual Case of Gastric Cancer Presenting with Breast Metastasis with Pleomorphic Microcalcifications

• Luk YS
• Ka SY
• Lo SS
• Chu CY
• Ma MW

• KMID: 2286463
• DOI: http://doi.org/10.4048/jbc.2012.15.3.356

Abstract

Breast metastasis from gastric carcinoma is rare. We present a case of right breast mass with microcalcification in which the diagnosis of poorly differentiated adenocarcinoma from the stomach was made after a biopsy. Pleomorphic microcalcification was noted in the ill-defined breast mass, which is a rare feature in breast metastasis. Since breast metastasis usually signifies advanced metastatic disease, differentiating primary breast cancer from metastasis is important for appropriate treatment.

Keyword

Breast neoplasms; Metastasis; Microcalcification; Stomach neoplasms

MeSH Terms

Adenocarcinoma
Biopsy
Breast
Breast Neoplasms
Neoplasm Metastasis
Stomach
Stomach Neoplasms

Figure

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  Figure 1 Mammographic findings. (A) Bilateral craniocaudal and medial-oblique views mammography of both breasts, cone-compression medialoblique view of the right breast mammography showing a large area of pleomorphic microcalcifications with architectural distortion in the upper outer quadrant of the right breast. (B) Ultrasonography revealed an ill-defined hypoechoic mass in the upper outer quadrant of the right breast.

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  Figure 2 Microscopic findings. (A, B) Immunohistochemical stain that showed cells from the right breast mass were negative for estrogen receptor and c-erbB-2 staining (Immunoperoxidase stain, ×200). (C, E) The malignant cells showed positivity in cytokeratin AE1/AE3, PAS-D, and E-cadherin staining (Immunoperoxidase stain, ×200). (D) (PAS stain, ×200). (F, G) A biopsy of the right breast mass showing infiltration of the stroma by malignant cells, most of which show signet ring features, compatible with metastasis from the stomach (H&E stain, ×200, ×400). (H) Pathological examination of bilateral ovarian lesions showing metastatic poorly differentiated adenocarcinoma with signet ring features (H&E stain, ×100). (I, J) Immunohistochemical examination of the ovarian lesions showed that the malignant cells were diffusely positive for cytokeratin 7 and focally positive of cytokeratin 20 (Immunoperoxidase stain, ×100).

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