Limits...
Metastatic colonic adenocarcinoma in breast: report of two cases and review of the literature.

Kothadia JP, Arju R, Kaminski M, Ankireddypalli A, Duddempudi S, Chow J, Giashuddin S - Case Rep Oncol Med (2015)

Bottom Line: Here we present two rare cases, in which colonic adenocarcinomas were found to metastasize to the breast.By immunohistochemical staining, it was confirmed that the neoplastic components were immunoreactive to colonic markers and nonreactive to breast markers, thus further supporting the morphologic findings.It is extremely important to make this distinction between primary breast cancer and a metastatic process, in order to provide the most effective and appropriate treatment for the patient and to avoid any harmful or unnecessary surgical procedures.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, The Brooklyn Hospital Center, An Academic Affiliate of Icahn School of Medicine at Mount Sinai, 121 DeKalb Avenue, Brooklyn, NY 11201, USA.

ABSTRACT
Metastatic adenocarcinoma to the breast from an extramammary site is extremely rare. In the literature, the most current estimate is that extramammary metastases account for only 0.43% of all breast malignancies and that, of these extramammary sites, colon cancer metastases form a very small subset. Most commonly seen metastasis in breast is from a contralateral breast carcinoma, followed by metastasis from hematopoietic neoplasms, malignant melanoma, sarcoma, lung, prostate, and ovary and gastric neoplasms. Here we present two rare cases, in which colonic adenocarcinomas were found to metastasize to the breast. In both cases, core biopsies were obtained from the suspicious areas identified on mammogram. Histopathology revealed neoplastic proliferation of atypical glandular components within benign breast parenchyma which were morphologically consistent with metastatic adenocarcinoma. By immunohistochemical staining, it was confirmed that the neoplastic components were immunoreactive to colonic markers and nonreactive to breast markers, thus further supporting the morphologic findings. It is extremely important to make this distinction between primary breast cancer and a metastatic process, in order to provide the most effective and appropriate treatment for the patient and to avoid any harmful or unnecessary surgical procedures.

No MeSH data available.


Related in: MedlinePlus

Neoplastic colonic glands (A and B) show hyperchromatic, crowded nuclei, loss of nuclear polarity, and pseudostratification, intermixed with normal breast ducts (C). Necrosis is noted in neoplastic colonic glands (arrow) (Hematoxylin and Eosin stain, 200x magnification).
© Copyright Policy - open-access
Related In: Results  -  Collection


getmorefigures.php?uid=PMC4390182&req=5

fig5: Neoplastic colonic glands (A and B) show hyperchromatic, crowded nuclei, loss of nuclear polarity, and pseudostratification, intermixed with normal breast ducts (C). Necrosis is noted in neoplastic colonic glands (arrow) (Hematoxylin and Eosin stain, 200x magnification).

Mentions: Proliferation of well formed, dilated, and larger sized glands or complex glandular architecture with uniform, basally oriented nuclei and loss of nuclear polarity are commonly seen histologic features that could be observed in both primary ductal adenocarcinoma and metastatic adenocarcinoma of colorectal origin. In both cases presented in this report, on Hematoxylin and Eosin stain, there were proliferation of cuboidal to columnar shaped cells with nuclear hyperchromasia, pseudostratification, and prominent nucleoli. In the majority of the cases, a constellation of nuclear hyperchromasia, pseudostratification, and intraglandular tumor necrosis are more suggestive of colorectal origin (Figure 5) [11]. Our cases show somewhat similar histomorphologic features to those described above and are not readily compatible with a primary breast tumor. Mucinous differentiations, microcalcifications, and the presence of intraglandular tumor necrosis are a few histologic features shared by both primary breast ductal adenocarcinomas and metastatic carcinoma in the breast of colorectal origin. Although rarely seen in the event of colorectal carcinomas, microcalcifications are more commonly associated with primary ductal adenocarcinoma of breast, as seen in our cases (Figure 6).


Metastatic colonic adenocarcinoma in breast: report of two cases and review of the literature.

Kothadia JP, Arju R, Kaminski M, Ankireddypalli A, Duddempudi S, Chow J, Giashuddin S - Case Rep Oncol Med (2015)

Neoplastic colonic glands (A and B) show hyperchromatic, crowded nuclei, loss of nuclear polarity, and pseudostratification, intermixed with normal breast ducts (C). Necrosis is noted in neoplastic colonic glands (arrow) (Hematoxylin and Eosin stain, 200x magnification).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4390182&req=5

fig5: Neoplastic colonic glands (A and B) show hyperchromatic, crowded nuclei, loss of nuclear polarity, and pseudostratification, intermixed with normal breast ducts (C). Necrosis is noted in neoplastic colonic glands (arrow) (Hematoxylin and Eosin stain, 200x magnification).
Mentions: Proliferation of well formed, dilated, and larger sized glands or complex glandular architecture with uniform, basally oriented nuclei and loss of nuclear polarity are commonly seen histologic features that could be observed in both primary ductal adenocarcinoma and metastatic adenocarcinoma of colorectal origin. In both cases presented in this report, on Hematoxylin and Eosin stain, there were proliferation of cuboidal to columnar shaped cells with nuclear hyperchromasia, pseudostratification, and prominent nucleoli. In the majority of the cases, a constellation of nuclear hyperchromasia, pseudostratification, and intraglandular tumor necrosis are more suggestive of colorectal origin (Figure 5) [11]. Our cases show somewhat similar histomorphologic features to those described above and are not readily compatible with a primary breast tumor. Mucinous differentiations, microcalcifications, and the presence of intraglandular tumor necrosis are a few histologic features shared by both primary breast ductal adenocarcinomas and metastatic carcinoma in the breast of colorectal origin. Although rarely seen in the event of colorectal carcinomas, microcalcifications are more commonly associated with primary ductal adenocarcinoma of breast, as seen in our cases (Figure 6).

Bottom Line: Here we present two rare cases, in which colonic adenocarcinomas were found to metastasize to the breast.By immunohistochemical staining, it was confirmed that the neoplastic components were immunoreactive to colonic markers and nonreactive to breast markers, thus further supporting the morphologic findings.It is extremely important to make this distinction between primary breast cancer and a metastatic process, in order to provide the most effective and appropriate treatment for the patient and to avoid any harmful or unnecessary surgical procedures.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, The Brooklyn Hospital Center, An Academic Affiliate of Icahn School of Medicine at Mount Sinai, 121 DeKalb Avenue, Brooklyn, NY 11201, USA.

ABSTRACT
Metastatic adenocarcinoma to the breast from an extramammary site is extremely rare. In the literature, the most current estimate is that extramammary metastases account for only 0.43% of all breast malignancies and that, of these extramammary sites, colon cancer metastases form a very small subset. Most commonly seen metastasis in breast is from a contralateral breast carcinoma, followed by metastasis from hematopoietic neoplasms, malignant melanoma, sarcoma, lung, prostate, and ovary and gastric neoplasms. Here we present two rare cases, in which colonic adenocarcinomas were found to metastasize to the breast. In both cases, core biopsies were obtained from the suspicious areas identified on mammogram. Histopathology revealed neoplastic proliferation of atypical glandular components within benign breast parenchyma which were morphologically consistent with metastatic adenocarcinoma. By immunohistochemical staining, it was confirmed that the neoplastic components were immunoreactive to colonic markers and nonreactive to breast markers, thus further supporting the morphologic findings. It is extremely important to make this distinction between primary breast cancer and a metastatic process, in order to provide the most effective and appropriate treatment for the patient and to avoid any harmful or unnecessary surgical procedures.

No MeSH data available.


Related in: MedlinePlus