J Korean Surg Soc.  2011 Dec;81(Suppl 1):S43-S46. 10.4174/jkss.2011.81.Suppl1.S43.

Metastasis to the breast from colonic adenocarcinoma

• Noh KT
• Oh B
• Sung SH
• Lee RA
• Chung SS
• Moon BI
• Kim KH

• KMID: 1445784
• DOI: http://doi.org/10.4174/jkss.2011.81.Suppl1.S43

Abstract

A 63-year-old woman was referred to a breast surgeon with a breast mass discovered incidentally during follow-up study after colon cancer surgery. Invasive adenocarcinoma was revealed on core needle biopsy. Wide excision of the breast including the tumor was performed. On standard histological examination the tumor showed features of moderately differentiated adenocarcinoma. The immunohistochemistry study revealed positive results for cytokeratin (CK)20 and CDX2, but negative for CK7. These are typical characteristics for colon cancer. Considering her history of subtotal colectomy for sigmoid colon cancer, it is presumable that the mass in the breast was of colonic origin, and it was an extremely rare case of metastasis to the breast from primary colorectal neoplasm. Although the instance is rare, clinicians should keep the possibility of breast metastasis from colorectal cancer in mind for early and correct diagnosis.

Keyword

Breast; Neoplasm metastasis; Colon cancer

MeSH Terms

Adenocarcinoma
Biopsy, Large-Core Needle
Breast
Colectomy
Colon
Colonic Neoplasms
Colorectal Neoplasms
Female
Follow-Up Studies
Humans
Immunohistochemistry
Keratins
Middle Aged
Neoplasm Metastasis
Sigmoid Neoplasms
Keratins

Figure

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  Fig. 1 Mild hypermetabolic lesion was seen in lower inner quadrant of right breast (arrow) and focal hypermetabolic lymph node was seen in right axillary area (arrow head).

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  Fig. 2 1.7 cm sized irregular, whitish-gray, firm mass was identified in lower inner portion of right breast, 3.5 cm apart from nipple.

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  Fig. 3 Cuboidal to columnar tumor cells with eosinophilic cytoplasm and pseudostratification were seen on hematoxylineosin stain (×100).

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  Fig. 4 Immunohistochemistry showed neoplastic cells were positive for CDX2 immunostaining (A, ×200) and cytokeratin 20 immunostaining (B, ×200).

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