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Tumour-to-tumour metastasis: male breast carcinoma metastasis arising in an extrapleural solitary fibrous tumour - a case report.

Scheipl S, Moinfar F, Leithner A, Sadoghi P, Jorgensen M, Rinner B, Liegl B - Diagn Pathol (2014)

Bottom Line: The patient received palliative chemotherapy but died of disease seven years after initial diagnosis.The abundance of blood vessels within these lesions might predispose SFTs for an involvement in TTM.This case describes the possibility of concurrent rare occurrences and reminds clinicians, as well as pathologists, to be open-minded and fastidious about their differential diagnoses, sampling and examination of histological specimens.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics and Orthopaedic Surgery, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, Austria. susanne.scheipl@gmx.at.

ABSTRACT

Background: Tumour-to-tumour metastasis (TTM) occurs when one tumour metastasises to a separate tumour within the same individual. TTM is observed frequently in breast cancer but has not been described in male breast cancer. In addition reports describing solitary fibrous tumours (SFT) of the pleura hosting other neoplasms' metastases are limited. We report an exceptional case of male breast cancer metastasising to an extrapleural SFT, occurring in the subcutaneous tissue of the back of a 68-year old Caucasian patient.

Case presentation: A 68-year old male was diagnosed with a metastasising ductal breast cancer. He was treated by mastectomy of the right breast and axillary lymph-adenectomy. Further staging revealed an increasing subcutaneous expansion located on the patient's back. Excision biopsy confirmed a SFT hosting a breast cancer metastasis. The patient received palliative chemotherapy but died of disease seven years after initial diagnosis.

Conclusions: The abundance of blood vessels within these lesions might predispose SFTs for an involvement in TTM. This case describes the possibility of concurrent rare occurrences and reminds clinicians, as well as pathologists, to be open-minded and fastidious about their differential diagnoses, sampling and examination of histological specimens.

Virtual slides: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/13000_2014_203.

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Related in: MedlinePlus

“Extrapleural SFT hosting a male breast cancer metastasis”. A) Classic morphology of a SFT. B) Ductal structures within a SFT representing the metastasis of a male ductal adenocarcinoma of the breast. The ductal adenocarcinoma shows strong CK7 expression (insert). C) Higher power view of the metastasis within the SFT. D-F) The ductal adenocarcinoma is positive for estrogen (D), BRST2 (E), and mammoglobin (F). G) The SFT component shows strong CD34 expression. H) The SFT expresses STAT6.
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Fig1: “Extrapleural SFT hosting a male breast cancer metastasis”. A) Classic morphology of a SFT. B) Ductal structures within a SFT representing the metastasis of a male ductal adenocarcinoma of the breast. The ductal adenocarcinoma shows strong CK7 expression (insert). C) Higher power view of the metastasis within the SFT. D-F) The ductal adenocarcinoma is positive for estrogen (D), BRST2 (E), and mammoglobin (F). G) The SFT component shows strong CD34 expression. H) The SFT expresses STAT6.

Mentions: Macroscopic examination revealed a solid, grayish lesion with a maximum diameter of 8 cm. Histological examination showed a mesenchymal tumour composed of a mix of round-oval to spindle shaped tumour cells with indistinct cell borders (Figure 1A). The tumour cells were set within a collagenous stroma, and arranged in a random pattern. Mast cells were present. A prominent “haemangiopericytoma-like” vascular architecture was seen. The mesenchymal tumor component showed focal mild nuclear atypia. Necrotic areas were not present and mitoses were scarce (3/10 HPF). Within the tumor, nests of epithelial cells and ductal structures were seen (Figure 1B and C). The epithelial tumor component demonstrated only mild to moderate nuclear atypia.Figure 1


Tumour-to-tumour metastasis: male breast carcinoma metastasis arising in an extrapleural solitary fibrous tumour - a case report.

Scheipl S, Moinfar F, Leithner A, Sadoghi P, Jorgensen M, Rinner B, Liegl B - Diagn Pathol (2014)

“Extrapleural SFT hosting a male breast cancer metastasis”. A) Classic morphology of a SFT. B) Ductal structures within a SFT representing the metastasis of a male ductal adenocarcinoma of the breast. The ductal adenocarcinoma shows strong CK7 expression (insert). C) Higher power view of the metastasis within the SFT. D-F) The ductal adenocarcinoma is positive for estrogen (D), BRST2 (E), and mammoglobin (F). G) The SFT component shows strong CD34 expression. H) The SFT expresses STAT6.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4260247&req=5

Fig1: “Extrapleural SFT hosting a male breast cancer metastasis”. A) Classic morphology of a SFT. B) Ductal structures within a SFT representing the metastasis of a male ductal adenocarcinoma of the breast. The ductal adenocarcinoma shows strong CK7 expression (insert). C) Higher power view of the metastasis within the SFT. D-F) The ductal adenocarcinoma is positive for estrogen (D), BRST2 (E), and mammoglobin (F). G) The SFT component shows strong CD34 expression. H) The SFT expresses STAT6.
Mentions: Macroscopic examination revealed a solid, grayish lesion with a maximum diameter of 8 cm. Histological examination showed a mesenchymal tumour composed of a mix of round-oval to spindle shaped tumour cells with indistinct cell borders (Figure 1A). The tumour cells were set within a collagenous stroma, and arranged in a random pattern. Mast cells were present. A prominent “haemangiopericytoma-like” vascular architecture was seen. The mesenchymal tumor component showed focal mild nuclear atypia. Necrotic areas were not present and mitoses were scarce (3/10 HPF). Within the tumor, nests of epithelial cells and ductal structures were seen (Figure 1B and C). The epithelial tumor component demonstrated only mild to moderate nuclear atypia.Figure 1

Bottom Line: The patient received palliative chemotherapy but died of disease seven years after initial diagnosis.The abundance of blood vessels within these lesions might predispose SFTs for an involvement in TTM.This case describes the possibility of concurrent rare occurrences and reminds clinicians, as well as pathologists, to be open-minded and fastidious about their differential diagnoses, sampling and examination of histological specimens.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics and Orthopaedic Surgery, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, Austria. susanne.scheipl@gmx.at.

ABSTRACT

Background: Tumour-to-tumour metastasis (TTM) occurs when one tumour metastasises to a separate tumour within the same individual. TTM is observed frequently in breast cancer but has not been described in male breast cancer. In addition reports describing solitary fibrous tumours (SFT) of the pleura hosting other neoplasms' metastases are limited. We report an exceptional case of male breast cancer metastasising to an extrapleural SFT, occurring in the subcutaneous tissue of the back of a 68-year old Caucasian patient.

Case presentation: A 68-year old male was diagnosed with a metastasising ductal breast cancer. He was treated by mastectomy of the right breast and axillary lymph-adenectomy. Further staging revealed an increasing subcutaneous expansion located on the patient's back. Excision biopsy confirmed a SFT hosting a breast cancer metastasis. The patient received palliative chemotherapy but died of disease seven years after initial diagnosis.

Conclusions: The abundance of blood vessels within these lesions might predispose SFTs for an involvement in TTM. This case describes the possibility of concurrent rare occurrences and reminds clinicians, as well as pathologists, to be open-minded and fastidious about their differential diagnoses, sampling and examination of histological specimens.

Virtual slides: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/13000_2014_203.

Show MeSH
Related in: MedlinePlus