Unusual presentation of breast cancer with retroperitoneal lymph node mestastases
Abstract: Breast cancer is the most frequent malignant tumor in women. 64.7 new cases are diagnosed per 100,000 inhabitants per year in Argentina and it is estimated that one in eight women will develop the disease during her lifetime. In turn, one in five breast cancer patients may develo...
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| Formato: | Artículo revista |
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Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
2021
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| Acceso en línea: | https://revistas.unc.edu.ar/index.php/med/article/view/34996 |
| Aporte de: |
| id |
I10-R327-article-34996 |
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ojs |
| institution |
Universidad Nacional de Córdoba |
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I-10 |
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R-327 |
| container_title_str |
Revista de la Facultad de Ciencias Médicas de Córdoba |
| format |
Artículo revista |
| topic |
Lymph Node Metastasis diagnosis Breast cancer Cancer of the Uterine Cervix Metástasis linfática diagnóstico Cáncer de mama Cáncer de cuello uterino |
| spellingShingle |
Lymph Node Metastasis diagnosis Breast cancer Cancer of the Uterine Cervix Metástasis linfática diagnóstico Cáncer de mama Cáncer de cuello uterino Franco , GF Medina , A Calafat , P Escobar , H Irico , S Moya , MP Kasparian , AC Unusual presentation of breast cancer with retroperitoneal lymph node mestastases |
| topic_facet |
Lymph Node Metastasis diagnosis Breast cancer Cancer of the Uterine Cervix Metástasis linfática diagnóstico Cáncer de mama Cáncer de cuello uterino |
| author |
Franco , GF Medina , A Calafat , P Escobar , H Irico , S Moya , MP Kasparian , AC |
| author_facet |
Franco , GF Medina , A Calafat , P Escobar , H Irico , S Moya , MP Kasparian , AC |
| author_sort |
Franco , GF |
| title |
Unusual presentation of breast cancer with retroperitoneal lymph node mestastases |
| title_short |
Unusual presentation of breast cancer with retroperitoneal lymph node mestastases |
| title_full |
Unusual presentation of breast cancer with retroperitoneal lymph node mestastases |
| title_fullStr |
Unusual presentation of breast cancer with retroperitoneal lymph node mestastases |
| title_full_unstemmed |
Unusual presentation of breast cancer with retroperitoneal lymph node mestastases |
| title_sort |
unusual presentation of breast cancer with retroperitoneal lymph node mestastases |
| description |
Abstract:
Breast cancer is the most frequent malignant tumor in women. 64.7 new cases are diagnosed per 100,000 inhabitants per year in Argentina and it is estimated that one in eight women will develop the disease during her lifetime. In turn, one in five breast cancer patients may develop ovarian metastases. However, the possibility of developing retroperitoneal metastases is an extremely infrequent event and there are very few cases reported in the scientific literature.
We report a very unusual presentation of retroperitoneal lymph node metastases in a woman with a dual malignant pathology: breast and cervical uterine cancer. We discuss the importance of diagnosing the origin of the metastases in relation to the treatment.
A 52 years old woman with an invasive lobular carcinoma diagnosed in 2001, T2, hormone receptor-negative, and scintigraphic images consistent with multiple bone metastases (stage 4). Chemotherapy and breast and axillary radiation therapy is indicated with a complete clincal response. In 2006 an invasive cervical uterine cancer is diagnosed, stage EIb1, and treated with surgery: Werthein-Meigs operation. The pathology shows an invasive squamous cell carcinoma of the cervix and a moderately differentiated metastatic adenocarcinoma in both ovaries and iliac lymph nodes whose likely origin is mammarian. Immunohistochemistry of the adenocarcinoma revealed 50% positivity for estrogen and 60% for progesterone receptors. The patient is currently on tamoxifen treatment.
It is very important to determine the primary origin of metastases since the therapeutic management is radically different: radiation therapy for cervical cancer and tamoxifen for breast cancer. The finding of positive hormone receptors certified the mammary origin of the metastases. But sometimes receptors are not expressed and negative results do not rule out breast origin. From our analysis two questions arise: 1) Why the primary breast tumor did not express hormone receptors while its metastases did? 2) Was the metastatic pathway to the retroperitoneal nodes direct from the breast cancer or secondary through ovarian metastases? |
| publisher |
Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología |
| publishDate |
2021 |
| url |
https://revistas.unc.edu.ar/index.php/med/article/view/34996 |
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AT francogf unusualpresentationofbreastcancerwithretroperitoneallymphnodemestastases AT medinaa unusualpresentationofbreastcancerwithretroperitoneallymphnodemestastases AT calafatp unusualpresentationofbreastcancerwithretroperitoneallymphnodemestastases AT escobarh unusualpresentationofbreastcancerwithretroperitoneallymphnodemestastases AT iricos unusualpresentationofbreastcancerwithretroperitoneallymphnodemestastases AT moyamp unusualpresentationofbreastcancerwithretroperitoneallymphnodemestastases AT kasparianac unusualpresentationofbreastcancerwithretroperitoneallymphnodemestastases AT francogf presentacioninusualdecancerdemamaconmetastasisengangliosretroperitoneales AT medinaa presentacioninusualdecancerdemamaconmetastasisengangliosretroperitoneales AT calafatp presentacioninusualdecancerdemamaconmetastasisengangliosretroperitoneales AT escobarh presentacioninusualdecancerdemamaconmetastasisengangliosretroperitoneales AT iricos presentacioninusualdecancerdemamaconmetastasisengangliosretroperitoneales AT moyamp presentacioninusualdecancerdemamaconmetastasisengangliosretroperitoneales AT kasparianac presentacioninusualdecancerdemamaconmetastasisengangliosretroperitoneales |
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2024-09-03T21:02:55Z |
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I10-R327-article-349962024-04-15T16:19:09Z Unusual presentation of breast cancer with retroperitoneal lymph node mestastases Presentación inusual de cáncer de mama con metástasis en ganglios retroperitoneales Franco , GF Medina , A Calafat , P Escobar , H Irico , S Moya , MP Kasparian , AC Lymph Node Metastasis diagnosis Breast cancer Cancer of the Uterine Cervix Metástasis linfática diagnóstico Cáncer de mama Cáncer de cuello uterino Abstract: Breast cancer is the most frequent malignant tumor in women. 64.7 new cases are diagnosed per 100,000 inhabitants per year in Argentina and it is estimated that one in eight women will develop the disease during her lifetime. In turn, one in five breast cancer patients may develop ovarian metastases. However, the possibility of developing retroperitoneal metastases is an extremely infrequent event and there are very few cases reported in the scientific literature. We report a very unusual presentation of retroperitoneal lymph node metastases in a woman with a dual malignant pathology: breast and cervical uterine cancer. We discuss the importance of diagnosing the origin of the metastases in relation to the treatment. A 52 years old woman with an invasive lobular carcinoma diagnosed in 2001, T2, hormone receptor-negative, and scintigraphic images consistent with multiple bone metastases (stage 4). Chemotherapy and breast and axillary radiation therapy is indicated with a complete clincal response. In 2006 an invasive cervical uterine cancer is diagnosed, stage EIb1, and treated with surgery: Werthein-Meigs operation. The pathology shows an invasive squamous cell carcinoma of the cervix and a moderately differentiated metastatic adenocarcinoma in both ovaries and iliac lymph nodes whose likely origin is mammarian. Immunohistochemistry of the adenocarcinoma revealed 50% positivity for estrogen and 60% for progesterone receptors. The patient is currently on tamoxifen treatment. It is very important to determine the primary origin of metastases since the therapeutic management is radically different: radiation therapy for cervical cancer and tamoxifen for breast cancer. The finding of positive hormone receptors certified the mammary origin of the metastases. But sometimes receptors are not expressed and negative results do not rule out breast origin. From our analysis two questions arise: 1) Why the primary breast tumor did not express hormone receptors while its metastases did? 2) Was the metastatic pathway to the retroperitoneal nodes direct from the breast cancer or secondary through ovarian metastases? Resumen: El cáncer de mama es el tumor maligno mas frecuente en la mujer. Se diagnostican 64.7 nuevos casos por 100.000 habitantes por año en la Argentina y se estima que una de cada ocho mujeres desarrollará la enfermedad durante su vida. A su vez, una de cada cinco pacientes con cáncer de mama puede desarrollar metástasis ováricas. Sin embargo, la posibilidad de desarrollar metástasis retroperitoneales constituye un evento extremadamente infrecuente y existen muy pocos casos reportados en la literatura científica. Comunicamos una presentación muy inusual de metástasis ganglionares retroperitoneales en una mujer con una doble patología tumoral: mamaria y cervical uterina. Planteamos la importancia del diagnóstico del origen de las metástasis en relación al tratamiento. Paciente de 52 años de edad, con diagnóstico de cáncer de mama lobulillar invasor en el año 2001, T2, con receptores hormonales negativos, y con imágenes centellográficas compatibles con metástasis óseas múltiples (estadio 4). Se le indica quimioterapia y radioterapia mamaria y axilar con respuesta clínica completa. En el año 2006 presenta un cáncer invasor de cuello uterino, estadio EIb1 y es tratada con cirugía: operación de Wertheim Meiggs. la anatomía patológica diagnostica un carcinoma epidermoide invasor en cuello de útero y un adenocarcinoma moderadamente diferenciado metastásico en ambos ovarios y en ganglios linfáticos ilíacos, de probable origen mamario. La inmunohistoquímica del adenocarcinoma reveló un 50% de positividad para receptores estrogénicos y 60% para progesterona. Actualmente la paciente se encuentra con tratamiento con tamoxifeno. Es muy importante determinar el origen primario de las metástasis ya que el manejo terapéutico es radicalmente diferente: radioterapia para el cáncer cervicouterino y tamoxifeno para el de origen mamario. La presencia de receptores hormonales positivos reveló el origen mamario de las metástasis. Pero a veces no se expresan y los resultados negativos no descartan el origen mamario. Surgen dos interrogantes: 1) ¿Por qué el tumor mamario primario no expresó receptores hormonales y, en cambio sí lo hicieron las metástasis? 2) ¿la vía metastásica hacia los ganglios retroperitoneales fue directa desde la mama o fue secundaria a través de las metástasis ováricas? Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2021-10-12 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion texto texto texto https://revistas.unc.edu.ar/index.php/med/article/view/34996 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 78 No. Suplemento (2021): Suplemento JIC XXII Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 78 Núm. Suplemento (2021): Suplemento JIC XXII Revista da Faculdade de Ciências Médicas de Córdoba; v. 78 n. Suplemento (2021): Suplemento JIC XXII 1853-0605 0014-6722 http://creativecommons.org/licenses/by-nc/4.0 |