J Breast Cancer.  2009 Jun;12(2):113-116. 10.4048/jbc.2009.12.2.113.

An Endobronchial Metastasis from Breast Cancer Seven Years after Modified Radical Mastectomy: A Case Report

• Maeng IH
• Kang HH
• Kang MK
• Song YM
• Lee SH
• Moon HS
• Min KO
• Lee BY
• Park CB
• Jin U
• Choi SH

• KMID: 2175212
• DOI: http://doi.org/10.4048/jbc.2009.12.2.113

Abstract

A 39-year-old woman was admitted to our hospital because of her chronic cough. She had undergone modified radical mastectomy for breast cancer 7 year before admission. A chest radiograph showed collapse of the left upper lobe (LUL) and computed tomography of the chest revealed a mass in the proximal portion of the LUL bronchus and distal atelectasis. Bronchoscopy showed obstruction of the LUL bronchus. The microscopic examination showed findings consistent with breast cancer with the same immunohistochemical features for the hormone receptors, as compared to those features of the previously resected tumor. Positron emission tomography showed increased fluorodeoxyglucose uptake only in the LUL. Left upper lobectomy was performed and she is now undergoing systemic chemotherapy. We report here on this rare case to emphasize that when a patient with a history of breast cancer complains of respiratory symptoms, and even though the patient was treated curatively a long time ago, we should suspect the possibility of endobronchial metastasis.

Keyword

Breast neoplasm; Lung neoplasm; Endobronchial Metastasis

MeSH Terms

Adult
Breast
Breast Neoplasms
Bronchi
Bronchoscopy
Cough
Female
Humans
Lung Neoplasms
Mastectomy, Modified Radical
Neoplasm Metastasis
Positron-Emission Tomography
Pulmonary Atelectasis
Thorax

Figure

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  Figure 1 A posteroanterior chest radiograph shows a poorly defined increased opacity in left suprahilar area and superior displacement of the left hilum, suggesting collapse of left upper lobe.

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  Figure 2 A contrast medium-enhanced computed tomography scan demonstrates a space occupying lesion (arrows) in left upper lobar bronchus and resultant atelectasis of left upper lobe.

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  Figure 3 Flexible bronchoscopy shows obstruction of left upper lobar bronchus with hyperemic mucosal change.

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  Figure 4 Microscopic examinations of bronchoscopic biopsy specimen shows pleomorphic, poorly differentiated carcinoma (A, H&E stain, ×400). Immunohistochemical stain demonstrates positive reactivity to both estrogen (B, ×400) and progesterone receptors (C, ×400).

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  Figure 5 Microscopic examinations of mastectomy specimen shows poorly differentiated adenocarcinoma (A, H&E stain, ×400). Immunohistochemical stain demonstrates positive reactivity to both estrogen (B, ×400) and progesterone receptors (C, ×400).

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  Figure 6 Left upper lobectomy specimen shows two ivory colored masses. Left upper lobe is obstructed by a larger mass, measured 3.0×2.0 cm in size and another one, 2.0×1.0 cm in size is located in the peripheral lung parenchyme.

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