J Korean Soc Radiol.  2010 Oct;63(4):391-394.

Metastasis of Breast Carcinoma to Intercostal Muscle Detected by Breast MRI: A Case Report

• Cho KE
• Son EJ
• Kim JA
• Youk JH
• Kim EK
• Kwak JY
• Jeong J

Abstract

Breast cancer can metastasize to any organ; however, distant metastases are unusual at the time of diagnosis. Furthermore metastasis to skeletal muscle is an uncommon manifestation of malignancy. We report a case of a 45-year-old woman diagnosed with cancer of the left breast with metastases to the ipsilateral intercostal muscle. To the best of our knowledge this is the first report of intercostal muscle metastasis from breast cancer in the English literature.

MeSH Terms

Breast
Breast Neoplasms
Female
Humans
Intercostal Muscles
Middle Aged
Muscle, Skeletal
Neoplasm Metastasis

Figure

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  Fig. 1 A 45-year-old woman with Lt. intercostal muscle metastasis from breast cancer. A. Non-enhanced T1-weighted axial image shows a low signal intensity lesion in the Lt. 7th intercostal muscle (solid arrow) and primary left breast cancer (open arrow). B. High signal intensity lesion at the Lt. 7th intercostal muscle (solid arrow) and primary left breast cancer (open arrow) on fat saturated T2-weighted axial image. C, D. Gd-DTPA enhanced T1-weighted axial image and subtraction axial MR image show an enhancing lesion measuring about 2.0 × 0.6 cm in the Lt. 7th intercostal muscle (solid arrow) and primary left breast cancer (open arrow).

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  Fig. 2 Axial image of PET scan shows increased FDG uptake foci in the Lt. anterior chest wall (black arrow, SUV=2.4) and left breast (open arrow, SUV=4.5).

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  Fig. 3 Ultrasonography shows an oval shaped, low echoic mass measuring about 1.8 × 0.6 cm in the left intercostal muscle. On color Doppler study, increased blood flow is not seen within the mass (not shown).

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  Fig. 4 Contrast enhanced axial CT image shows an enhancing lesion measuring about 2.0×0.6 cm in the left 7th intercostal muscle (arrow) and primary Lt. breast cancer (open arrow)

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  Fig. 5 A, B. Photomicrograph (Hematoxylin & Eosin staining, ×100 & ×400) of the left 7th intercostal mass specimen shows tumor cell nests dissecting the fascicles of the skeletal muscle and surrounding soft tissue with some tumor cells located in the lymphovascular spaces. The diagnosis is metastatic ductal carcinoma from the breast.

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