Abstract
Introduction
Although breast cancer is a major health problem worldwide, metastatic disease to the lower genital tract remains to be a rare event.
Case report
A 64-year old woman was admitted to our hospital due to newly diagnosed ascites and peripheral edema. A computer tomography had shown peritoneal carcinosis but no clear evidence of an intraabdominal mass. CA 12-5 levels were elevated. Physical examination of the breast did not show any abnormal findings, except for the fact that the patient was post bilateral breast augmentation in 1999. The peritoneal carcinosis was thought to originate from the ovaries or the endometrium and therefore the patient underwent a laparotomy with hysterectomy, bilateral salpingoovariectomy and omentectomy. Histological findings revealed a low differentiated adenocarcinoma, most likely originating from primary breast cancer. A bilateral mammography was suspicious of a tumour in the left breast which was confirmed in a second surgery. Histology showed a moderately differentiated invasive-lobular breast cancer.
Conclusion
To our knowledge, this is the first report about metastasis to the lower genital tract on initial presentation of an invasive-lobular carcinoma. In the differential diagnosis of peritoneal carcinosis, metastases of an invasive-lobular carcinoma should be considered.
References
Jemal A, Siegel R, Ward E, Hao Y, Xu J, Thun MJ (2009) Cancer statistics. CA Cancer J Clin 59(4):225–249. doi:10.3322/caac.20006
Famoriyo A, Sawant S, Banfield PJ (2004) Abnormal uterine bleeding as a presentation of metastatic breast disease in a patient with advanced breast cancer on tamoxifen therapy. Arch Gynecol Obstet 270(3):192–193. doi:10.1007/s00404-003-0500-2
Piura B, Yanai-Inbar I, Rabinovich A, Zalmanov S, Goldstein J (1999) Abnormal uterine bleeding as a presenting sign of metastases to the uterine corpus, cervix and vagina in a breast cancer patient on tamoxifen therapy. Eur J Obstet Gynecol Reprod Biol 83(1):57–61. doi:10.1016/S0301-2115(98)00268-1
Karvouni E, Papakonstantinou K, Dimopoulou C, Kairi-Vassilatou E, Hasiakos D, Gennatas CG, Kondi-Paphiti A (2009) Abnormal uterine bleeding as a presentation of metastatic breast disease in a patient with advanced breast cancer. Arch Gynecol Obstet 279(2):199–201. doi:10.1007/s00404-008-0665-9
Silverberg SG, Kurman RJ (1992) Atlas of Tumor Pathology: Tumors of the Uterine Corpus and Gestational Trophoblastic Disease, 3rd edn. Washington, 7 Armed Forces Institute of Pathology
Mazur MT, Hsueh S, Gersell DJ (1984) Metastases to the female genital tract. Analysis of 325 cases. Cancer 53(9):1978–1984
Erkanli S, Kayaselcuk F, Kuscu E, Bolat F, Sakalli H, Haberal A (2006) Lobular carcinoma of the breast metastatic to the uterus in a patient under adjuvant anastrozole therapy. Breast 15(4):558–561. doi:10.1016/j.breast.2005.10.008
Ustaalioglu BB, Bilici A, Seker M, Salman T, Gumus M, Barisik NO, Salepci T, Yaylaci M (2009) Metastasis of lobular breast carcinoma to the uterus in a patient under anastrozole therapy. Onkologie 32(7):424–426. doi:10.1159/000218367
Scopa CD, Aletra C, Lifschitz-Mercer B, Czernobilsky B (2005) Metastases of breast carcinoma to the uterus. Report of two cases, one harboring a primary endometrioid carcinoma, with review of the literature. Gynecol Oncol 96(2):543–547. doi:10.1016/j.ygyno.2004.09.064
Kemp B, Schröder W, Hermann A, Biesterfeld S, Rath W (1997) Uterine metastasis of invasive lobular breast carcinoma. Case report and review of the literature with reference to differential diagnostic problems and clinical consequences. Zentralbl Gynakol 119(10):500–502
Rau AR, Saldanha P, Raghuveer CV (2003) Metastatic lobular mammary carcinoma diagnosed in cervicovaginal smears: a case report. Diagn Cytopathol 29(5):300–302. doi:10.1002/dc.10385
Li CI, Uribe DJ, Daling JR (2005) Clinical characteristics of different histologic types of breast cancer. Br J Cancer 93(9):1046–1052. doi:10.1038/sj.bjc.6602787
Dian D, Herold H, Mylonas I, Scholz C, Janni W, Sommer H, Friese K (2009) Survival analysis between patients with invasive ductal and invasive lobular breast cancer. Arch Gynecol Obstet 279(1):23–28. doi:10.1007/s00404-008-0662-z
Bogliolo S, Morotti M, Valenzano Menada M, Fulcheri E, Musizzano Y, Casabona F (2010) Breast cancer with synchronous massive metastasis in the uterine cervix: a case report and review of the literature. Arch Gynecol Obstet 281(4):769–773. doi:10.1007/s00404-009-1264-0
Cannistra SA (2004) Cancer of the ovary. N Engl J Med 351(24):2519–2529
Handel N (2007) The effect of silicone implants on the diagnosis, prognosis, and treatment of breast cancer. Plast Reconstr Surg 120(7 Suppl 1):81S–93S. doi:10.1097/01.prs.0000286578.94102.2b
Deapen D (2007) Breast implants and breast cancer: a review of incidence, detection, mortality, and survival. Plast Reconstr Surg 120(7 Suppl 1):70S–80S. doi:10.1097/01.prs.0000286577.70026.5d
Kang BJ, Kim SH et al (2010) The clinical and imaging characteristics of breast cancers in patients with interstitial mammoplasty. Arch Gynecol Obstet 281(6):1029–1035. doi:10.1007/s00404-009-1276-9
Tarone RE, Lipworth L, Young VL, Mc Laughlin JK (2004) Breast reduction surgery and breast cancer risk: does reduction mammaplasty have a role in primary prevention strategies for women at high risk of breast cancer? Plast Reconstr Surg 113(7):2104–2110
Conflict of interest
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Engelstaedter, V., Mylonas, I. Lower genital tract metastases at time of first diagnosis of mammary invasive lobular carcinoma. Arch Gynecol Obstet 283 (Suppl 1), 93–95 (2011). https://doi.org/10.1007/s00404-011-1843-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00404-011-1843-8