J Breast Cancer.  2013 Dec;16(4):442-446. 10.4048/jbc.2013.16.4.442.

Random Synchronous Malignancy in Male Breast: A Case Report

Affiliations
  • 1Department of Nuclear Medicine & PET CT, Amrita Institute of Medical Sciences (Amrita Vishwa Vidyapeetham), Cochin, Kerala, India. drmanjitsarma@gmail.com

Abstract

We report here a case of a random synchronous male breast malignancy in a patient with a known base of tongue malignancy that was incidentally detected on a whole body 18-fluorine deoxyglucose positron emission tomography and computed tomography (18F-FDG PET/CT). Patient was referred to us for PET/CT staging and radiotherapy planning for a poorly differentiated squamous cell carcinoma of base of tongue. Histopathologically, the incidentally detected breast lesion was proven to be an invasive ductal carcinoma. 18F-FDG PET/CT being a whole body imaging modality is known to detect a considerable number of synchronous primaries. Synchronous malignancies in the head and neck area and the upper aerodigestive tract are well established. However, synchronous malignancy in male breast is reportedly uncommon. Our case is unique for the fact that a random synchronous dual malignancy of base of tongue and breast in a male patient was detected during a whole body 18F-FDG PET/CT imaging.

Keyword

Breast neoplasms; Male; Multiple primary neoplasms; Positron-emission tomography; Tongue neoplasms

MeSH Terms

Breast Neoplasms
Breast*
Carcinoma, Ductal
Carcinoma, Squamous Cell
Deoxyglucose
Fluorodeoxyglucose F18
Head
Humans
Male*
Neck
Neoplasms, Multiple Primary
Positron-Emission Tomography
Positron-Emission Tomography and Computed Tomography
Radiotherapy
Tongue
Tongue Neoplasms
Whole Body Imaging
Deoxyglucose
Fluorodeoxyglucose F18

Figure

  • Figure 1 Base of tongue (right side) lesion. (A) Stratified squamous mucosa with cells arranged in nests, islands (arrows) and cords in a desmoplastic stroma (H&E stain, ×100). (B) Cells with moderate keratinized cytoplasm (arrow) and pleomorphic hyperchromatic nuclei (H&E stain, ×400).

  • Figure 2 Positron emission tomography (PET) maximal intensity projection image showing the whole body PET image wherein both the base of tongue lesion (arrow) and the right breast lesion (arrowhead) are seen.

  • Figure 3 (A) Axial 18-Fluorine deoxyglucose positron emission tomography (18F-FDG PET), (B) axial computed tomography (CT) (contrast enhanced), (C) PET/CT fusion sections showing focal FDG uptake in right base of tongue with no corresponding CT lesion (triangulated).

  • Figure 4 (A) 18-fluorine deoxyglucose positron emission tomography (18F-FDG PET), (B) axial computed tomography (CT) (contrast enhanced), and (C) PET/CT fusion axial sections showing focal 18F-FDG uptake in the well defined 15×14 mm soft tissue subcutaneous lesion in retroareolar region on right side (triangulated).

  • Figure 5 Excision biopsy (right breast lump). (A) Infiltrating neoplasm composed of cells arranged in tubules, cords, singly and in islands (arrows) (H&E stain, ×100). Moderate cytoplasm and pleomorphic nuclei in cells. Invasive ductal carcinoma, not otherwise specified. Modified Bloom Richardson grade 1 (tubule 2, atypia 1, mitosis 1). (B) In higher magnification (H&E stain, ×400).


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