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Case Reports
. 2021 Jun 23:2021:3054232.
doi: 10.1155/2021/3054232. eCollection 2021.

Breast Cancer Metastasis in a Renal Carcinoma Pulmonary Metastasis: A Rare Example of Tumor-to-Tumor Metastasis

Áurea Lima  1   2   3 , Isa Peixoto  4 , Susana Sarandão  5 , Daniel Melo  6 , Ângelo Rodrigues  7 , Helena Pereira  5
Affiliations
Case Reports

Breast Cancer Metastasis in a Renal Carcinoma Pulmonary Metastasis: A Rare Example of Tumor-to-Tumor Metastasis

Áurea Lima et al. Case Rep Oncol Med. .

Abstract

The tumor-to-tumor metastasis phenomenon remains fairly uncommon, with fewer than 100 cases described to present time. Virtually any tumor can be a donor or a recipient neoplasm. Nevertheless, renal carcinomas have been implicated as the most common malignant tumors to harbor metastasis, while lung and breast tumors are the most frequent donors. This article reports an extremely rare case of a breast cancer metastasis in a lung metastasis of clear cell type renal cell carcinoma that met all Campbell and coworkers' tumor-to-tumor metastasis criteria. Additionally, we present the literature case reports of breast cancer metastasis in renal cell carcinomas and try to discuss the mechanisms underlying its occurrence. Since this phenomenon identification will impact the therapeutic strategy and it is not easily detected by image, the anatomopathological study of any and all suspicious lesions is of crucial importance. To the best of our knowledge, this is the first report of a metastasis inside a metastasis.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Transverse section of a thorax CT scan presenting an 8 mm pulmonary nodule.
Figure 2
Figure 2
PET/CT images showing an increased metabolic activity in the pulmonary suspected lesion.
Figure 3
Figure 3
Microscopic examination of the basal nodule biopsy specimen (H&E, 40x). Pulmonary parenchyma (upper left corner) with involvement of epithelial cells with the clear cytoplasm and well-defined cell membrane, interspersed within a highly vascularized stroma, compatible with ccRCC. Inside this, a distinct population cells, arranged in nests, with a more eosinophilic cytoplasm is identified, corresponding to the breast carcinoma.
Figure 4
Figure 4
Microscopic examination of the basal nodule biopsy specimen with a high-power field showing the two neoplastic components (H&E, 400x). Note the two mitotic figures on the breast cancer component.
Figure 5
Figure 5
Immunohistochemical stains. (a) (Cam5.2, 200x) Both neoplasms are positive for cytokeratins, confirming an epithelial origin of the two neoplastic populations. (b) (CD10, 200x) Strong and diffuse positivity for CD10, characteristic of ccRCC. Highlight the antibody's negativity in the breast carcinoma cell population. (c) (ER, 200x) Strong and nuclear positivity for the antibody directed to ER in breast carcinoma cells. Highlight the antibody's negativity in the ccRCC component.
Figure 6
Figure 6
Overview of the patient clinical history and management.
See this image and copyright information in PMC

References

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