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Case Reports
. 2021 Jan-Feb;35(1):453-459.
doi: 10.21873/invivo.12278.

Micropapillary Bladder Cancer Metastatic to the Breast: A Case Report and Brief Literature Review

Elena Lievore  1 , Letterio Runza  2 , Michele Ghidini  1 , Barbara Galassi  3 , Andrea Gallioli  1 , Carolina Bebi  1 , Luca Boeri  1 , Concetta Blundo  4 , Claudia Francesca Rossi  4 , Fabrizio Longo  1 , Giancarlo Albo  1   5 , Emanuele Montanari  1   5 , Elisa DE Lorenzis  6   5
Affiliations
Case Reports

Micropapillary Bladder Cancer Metastatic to the Breast: A Case Report and Brief Literature Review

Elena Lievore et al. In Vivo. 2021 Jan-Feb.

Abstract

Background: Bladder cancer (BC) usually metastasizes to the lymph nodes, bone, lung, liver and peritoneum, but rarely in the breast.

Case report: We present a case of a 66-year-old female diagnosed with a massive bladder tumor, who presented a right mammary nodule after neo-adjuvant chemotherapy. A biopsy of the nodule did not permit a definite diagnosis of metastatic spread, which was confirmed by excision of the nodule. In the literature, we found only 7 other similar cases of BC metastasis to the breast. Currently, a non-invasive method for differentiating a breast metastasis from primary cancer is lacking, although there are some clinical and radiological aspects that may help the diagnosis. Histological examination provides diagnostic certainty.

Conclusion: Breast metastases from BC are unusual and consequently difficult to identify without non-invasive tools. Clinical history and histological study play a pivotal role in determining the correct diagnosis.

Keywords: Metastasis; breast cancer; immunotherapy; neoadjuvant therapy; urothelial cancer.

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Conflict of interest statement

The Authors declare that there are no conflicts of interest regarding this study.

Figures

Figure 1
Figure 1. Radiological workup of metastasis to the breast (A) Contrast enhanced CT scan showing appearance of a right mammary nodule (arrow) (B) US appearance: a round hypoechoic mass in the lower outer quadrant of the right breast (C) Mammographic delimitation of the breast lesion before excision (cranio-caudal projection)
Figure 2
Figure 2. Histological examination of breast and bladder surgical excision specimen: (A) Healthy breast parenchyma on the left and metastatic micropapillary bladder cancer on the right (H&E, ×10), (B) micropapillary urothelial carcinoma with lymphovascular invasion of neoplastic cells (H&E stain, ×20), (C) positive nuclear staining for GATA3 (immunohistochemistry, ×10)
Figure 3
Figure 3. Immunohistochemistry analysis in mammary nodule excision: (A) CK20 positivity in mammary metastatic cells (immunohistochemistry, ×10), (B) negative mammoglobin in metastatic cells (immunohistochemistry, ×5), (C) negativity for GCDFP15 in metastatic cells (immunohistochemistry, ×5)
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