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Open Access Highly Accessed Case Report

Metastasis to the breast from an adenocarcinoma of the lung with extensive micropapillary component: a case report and review of the literature

Nicoletta Maounis12*, Maria Chorti3, Stella Legaki3, Eleni Ellina1, Aphrodite Emmanouilidou1, Maria Demonakou3 and Xanthi Tsiafaki4

Author Affiliations

1 Department of Clinical Cytology, Sismanoglio General Hospital, Athens, 151 26, Greece

2 Department of Pathology and Laboratory Medicine, Drexel University College of Medicine, Philadelphia, 19102, PA, USA

3 Department of Pathology, Sismanoglio General Hospital, Athens, 151 26, Greece

4 Department of Respiratory Medicine, Sismanoglio General Hospital, Athens, 151 26, Greece

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Diagnostic Pathology 2010, 5:82  doi:10.1186/1746-1596-5-82

Published: 17 December 2010

Abstract

Breast metastasis from extra-mammary malignancy is rare. Based on the literature an incidence of 0.4-1.3% is reported. The primary malignancies most commonly metastasizing to the breast are leukemia-lymphoma, and malignant melanoma. We present a case of metastasis to the breast from a pulmonary adenocarcinoma, with extensive micropapillary component, diagnosed concomitantly with the primary tumor. A 73-year-old female presented with dyspnea and dry cough of 4 weeks duration and a massive pleural effusion was found on a chest radiograph. Additionally, on physical examination a poorly defined mass was noted in the upper outer quadrant of the left breast. The patient underwent bronchoscopy, excisional breast biopsy and medical thoracoscopy. By cytology, histology and immunohistochemistry primary lung adenocarcinoma with metastasis to the breast and parietal pleura was diagnosed. Both the primary and metastatic anatomic sites demonstrated histologically extensive micropapillary component, which is recently recognized as an important prognostic factor. The patient received chemotherapy but passed away within 7 months. Accurate differentiation of metastatic from primary carcinoma is of crucial importance because the treatment and prognosis differ significantly.