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Case Reports
. 2022;41(1):407-411.
doi: 10.3233/BD-220027.

HPV-positive cervical squamous cell carcinoma metastasis to the breast, mimicking primary tumor

Idam de Oliveira-Junior  1   2   3 , Flávia Fazzio Barbin  4 , Anapaula Hidemi Uema Watanabe  5 , Ricardo Dos Reis  3   6 , René Aloisio da Costa Vieira  1   3   7
Affiliations
Case Reports

HPV-positive cervical squamous cell carcinoma metastasis to the breast, mimicking primary tumor

Idam de Oliveira-Junior et al. Breast Dis. 2022.

Abstract

Introduction: Metastatic disease to the breast is a rare condition, with contralateral breast metastasis being the most common primary site.

Case presentation: We present the case of a patient who underwent treatment for an HPV positive squamous cell carcinoma (SCC) of the cervix who, during follow-up, complained of a nodule in her left breast. Anatomopathological results indicating squamous carcinoma, which was not able to be differentiated from breast metaplastic carcinoma. Resection of the lesion was carried out, confirming carcinoma with squamous cell differentiation with negativity for GCDFP-15, mammaglobin, p63 and SOX10, but with positivity for p16 and for high risk HPV, confirming a single metastatic lesion of cervical carcinoma.

Discussion/conclusion: In the presence of SCC in the breast, the differential diagnosis may consider the presence of primary lesion, metaplastic carcinoma with squamous cell differentiation or metastatic disease. The use of markers such as p63, SOX10 and p16, may help for a definitive diagnosis.

Keywords: Cervical cancer; HPV; breast metastasis; metastasis.

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Figures

Fig. 1.
Fig. 1.
Left mammography in oblique mediolateral (a) and craniocaudal (b) views, featuring a high-density nodule, irregularly shaped and indistinct and spiculated margins, best assessed in tomosynthesis (c) and (d), located at the upper-outer quadrant, corresponding to the palpable complaint – BI-RADS® 4C. Ultrasonography (e) shows a nodule of solid, hypoechoic, irregular and angled nature.
Fig. 2.
Fig. 2.
Histology - (a) invasive carcinoma with squamous differentiation and keratinization in breast segmentectomy material (Histological section, hematoxylin and eosin, 100x); (b) strong and diffuse immunopositivity for the p16 marker (p16, DAKO, 200 x); (c and d) detection of signals by the in-situ hybridization technique (ISH) for high risk HPV (Ventana Infomr HPV III Family 16 probe for HPV genotypes 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58 and 66) - 200 and 400x increase, respectively.
See this image and copyright information in PMC

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