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Breast Metastasis from Medullary Thyroid Carcinoma in a Male Patient: Case Report and Review of the Literature.

Mandanas S, Margaritidou E, Christoforidou V, Karoglou E, Geranou C, Chrisoulidou A, Boudina M, Georgopoulos K, Pazaitou-Panayiotou K - Rare Tumors (2015)

Bottom Line: Due to the extension of the disease, treatment with vandetanib was decided, but serious adverse events led to its interruption after two weeks.Core needle biopsy and histological examination of the specimen confirmed the presence of metastatic MTC.Histological and/or cytopathological examination are requisite diagnostic tools, while external beam irradiation and tyrosine kinase inhibitors may be used as palliative therapies in the concurrent presence of breast metastases from MTC.

View Article: PubMed Central - PubMed

Affiliation: Department of Endocrinology, Theagenio Cancer Hospital , Thessaloniki, Greece.

ABSTRACT
Medullary thyroid carcinoma (MTC) is a rare malignancy that may metastasize to liver, lungs and bones. Breast is an unusual metastatic site for MTC and only 20 female cases have been reported in the literature. We present a male patient in whom histological examination and immunohistochemistry of a breast mass were indicative of breast metastasis from MTC. A 67-year-old man with recent diagnosis of MTC and metastases to cervical and upper mediastinum lymph nodes was referred to our department for further treatment. At first evaluation, diagnostic imaging techniques showed lung and bone metastases and three months later the presence of liver metastases. Due to the extension of the disease, treatment with vandetanib was decided, but serious adverse events led to its interruption after two weeks. During follow-up, patient developed a painful swelling in the right breast. Ultrasound and mammography showed the presence of multiple masses to the right breast suspicious for malignancy. Core needle biopsy and histological examination of the specimen confirmed the presence of metastatic MTC. Palliative external beam irradiation was used to relieve local pain and, after one month, the patient died. Consequently, breast masses should be cautiously evaluated, mainly in the presence of a known primary malignancy. Histological and/or cytopathological examination are requisite diagnostic tools, while external beam irradiation and tyrosine kinase inhibitors may be used as palliative therapies in the concurrent presence of breast metastases from MTC.

No MeSH data available.


Related in: MedlinePlus

Neoplastic cells (100×) stain positively for thyroid transcription factor-1 (TTF-1) (A). Neoplastic cells (200×) show strong reactivity for calcitonin (B). Neoplastic cells (100×) are negatively stained for estrogen receptor. The adjacent epithelial cells of a mammary duct show estrogen receptor reactivity and is considered as an internal positive control (C). Neoplastic cells (100×) are positively stained for chromogranin (D).
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fig004: Neoplastic cells (100×) stain positively for thyroid transcription factor-1 (TTF-1) (A). Neoplastic cells (200×) show strong reactivity for calcitonin (B). Neoplastic cells (100×) are negatively stained for estrogen receptor. The adjacent epithelial cells of a mammary duct show estrogen receptor reactivity and is considered as an internal positive control (C). Neoplastic cells (100×) are positively stained for chromogranin (D).

Mentions: Core needle biopsy of the mass revealed metastatic disease from the known MTC. The neoplasm was characterized by sheets and nests of round or slightly spindle cells in a fibrous tissue. Amyloid deposits have been identified with the Congo red histochemical stain. Tumor cells contained round to oval, regular hyperchromatic nuclei with occasional nucleoli. Mitosis was scant (Figure 3). Immunohistochemistry showed that the neoplastic cells were positive for calcitonin, chromogranin, synaptophysin, thyroid transcription factor-1 (TTF-1), low molecular weight keratins and negative for thyroglobulin (Figure 4).


Breast Metastasis from Medullary Thyroid Carcinoma in a Male Patient: Case Report and Review of the Literature.

Mandanas S, Margaritidou E, Christoforidou V, Karoglou E, Geranou C, Chrisoulidou A, Boudina M, Georgopoulos K, Pazaitou-Panayiotou K - Rare Tumors (2015)

Neoplastic cells (100×) stain positively for thyroid transcription factor-1 (TTF-1) (A). Neoplastic cells (200×) show strong reactivity for calcitonin (B). Neoplastic cells (100×) are negatively stained for estrogen receptor. The adjacent epithelial cells of a mammary duct show estrogen receptor reactivity and is considered as an internal positive control (C). Neoplastic cells (100×) are positively stained for chromogranin (D).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4508642&req=5

fig004: Neoplastic cells (100×) stain positively for thyroid transcription factor-1 (TTF-1) (A). Neoplastic cells (200×) show strong reactivity for calcitonin (B). Neoplastic cells (100×) are negatively stained for estrogen receptor. The adjacent epithelial cells of a mammary duct show estrogen receptor reactivity and is considered as an internal positive control (C). Neoplastic cells (100×) are positively stained for chromogranin (D).
Mentions: Core needle biopsy of the mass revealed metastatic disease from the known MTC. The neoplasm was characterized by sheets and nests of round or slightly spindle cells in a fibrous tissue. Amyloid deposits have been identified with the Congo red histochemical stain. Tumor cells contained round to oval, regular hyperchromatic nuclei with occasional nucleoli. Mitosis was scant (Figure 3). Immunohistochemistry showed that the neoplastic cells were positive for calcitonin, chromogranin, synaptophysin, thyroid transcription factor-1 (TTF-1), low molecular weight keratins and negative for thyroglobulin (Figure 4).

Bottom Line: Due to the extension of the disease, treatment with vandetanib was decided, but serious adverse events led to its interruption after two weeks.Core needle biopsy and histological examination of the specimen confirmed the presence of metastatic MTC.Histological and/or cytopathological examination are requisite diagnostic tools, while external beam irradiation and tyrosine kinase inhibitors may be used as palliative therapies in the concurrent presence of breast metastases from MTC.

View Article: PubMed Central - PubMed

Affiliation: Department of Endocrinology, Theagenio Cancer Hospital , Thessaloniki, Greece.

ABSTRACT
Medullary thyroid carcinoma (MTC) is a rare malignancy that may metastasize to liver, lungs and bones. Breast is an unusual metastatic site for MTC and only 20 female cases have been reported in the literature. We present a male patient in whom histological examination and immunohistochemistry of a breast mass were indicative of breast metastasis from MTC. A 67-year-old man with recent diagnosis of MTC and metastases to cervical and upper mediastinum lymph nodes was referred to our department for further treatment. At first evaluation, diagnostic imaging techniques showed lung and bone metastases and three months later the presence of liver metastases. Due to the extension of the disease, treatment with vandetanib was decided, but serious adverse events led to its interruption after two weeks. During follow-up, patient developed a painful swelling in the right breast. Ultrasound and mammography showed the presence of multiple masses to the right breast suspicious for malignancy. Core needle biopsy and histological examination of the specimen confirmed the presence of metastatic MTC. Palliative external beam irradiation was used to relieve local pain and, after one month, the patient died. Consequently, breast masses should be cautiously evaluated, mainly in the presence of a known primary malignancy. Histological and/or cytopathological examination are requisite diagnostic tools, while external beam irradiation and tyrosine kinase inhibitors may be used as palliative therapies in the concurrent presence of breast metastases from MTC.

No MeSH data available.


Related in: MedlinePlus