J Korean Soc Radiol.  2015 Dec;73(6):393-397. 10.3348/jksr.2015.73.6.393.

Breast Metastasis from Gastric Adenocarcinoma Mimicking Normal Breast Parenchyma on Ultrasound: A Case Report

• Lee J
• Lee JH
• Park MK
• Park YM
• Kim DC
• Lee M
• Cho SH

• KMID: 2130945
• DOI: http://doi.org/10.3348/jksr.2015.73.6.393

Abstract

Breast metastases from extramammary malignancies are uncommon. Although metastatic lesions show variable radiologic features, there have been few reports of metastatic breast cancer with negative sonographic findings. Furthermore, the results of several studies have indicated a high negative predictive value when ultrasonographic and mammographic findings were normal in the setting of a palpable lump, and follow-up is recommended when the physical examination is not highly suspicious. Herein, we report a case of a 26-year-old woman with breast metastasis from a known gastric adenocarcinoma, which had negative findings without any evidence of suspicious features for malignancy on the initial mammogram and ultrasound.

MeSH Terms

Adenocarcinoma*
Adult
Breast Neoplasms
Breast*
Female
Follow-Up Studies
Humans
Mammography
Neoplasm Metastasis*
Physical Examination
Ultrasonography*
Ultrasonography, Mammary

Figure

• 

  Fig. 1 A 26-year-old female with a palpable lump in the left breast. A. Initial ultrasonographic (US) of the palpable area at the left 10-o'clock position shows heterogeneous fibroglandular tissue without a discrete mass lesion. B. Symmetric parenchymal echotexture is noted in the corresponding area of the contralateral breast (right 2-o'clock). C, D. Left craniocaudal (C) and mediolateral oblique (D) mammograms show extremely dense parenchyma and no abnormal findings at the palpable radiopaque BB marker area (black arrows) of the left-upper inner breast. E. Follow-up US after 1 month was conducted due to an enlargement of the palpable breast lump. Targeted US shows a further heterogeneous echotexture characterized by large areas of decreased echogenecity without a discrete mass lesion. Skin thickening is also observed. F. US of the ipsilateral axillary lymph node shows eccentric cortical thickening (white arrow).

• 

  Fig. 2 Histopathology of the breast biopsy specimen. A. The tumor cells seem to be signet ring cells with abundant intracytoplasmic mucin (arrows), and poorly differentiated small pleomorphic features are frequently recognized as well (hematoxylin and eosin, × 200). B, C. Cytokeratin (CK) 20 (B) and CK7 (C) staining are both positive (× 400).

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