A Rare Case of Breast Metastasis from a Primary Lung Tumor: Case Report

Abstract

Breast metastasis originating from a primary lung tumor is exceedingly rare and can present challenges in distinguishing it from primary breast cancer. This case report discusses the management of a 64-year-old woman who initially presented with a nodule in her left breast. A biopsy revealed an infiltrating ductal carcinoma. Despite negative BRCA genetic testing, her significant family history of cancer and the presence of a newly detected right breast lesion led to a bilateral mastectomy. Post-operative imaging identified multiple hypodense nodules and a spiculated pulmonary nodule, necessitating further investigation. An endoscopic lung biopsy confirmed a primary pulmonary carcinoma with histological features similar to the breast carcinoma, suggesting the lung as the primary source. This case highlights the complexity of differentiating breast metastasis originating from a lung tumor and primary breast cancer. It underscores the importance of comprehensive diagnostic evaluations and the consideration of extramammary origins in metastatic cases. The findings emphasize the role of multidisciplinary teams in managing such rare and challenging cases and highlight the necessity for thorough and repeated assessments in atypical breast cancer presentations.

Keywords: breast cancer; breast metastasis; lung cancer.

Figure 1

Cytokeratin 7 (CK7). CK7 expression appears diffuse and intense in the neoplasm and in the healthy breast tissue (upper right side).

Figure 2

Hematoxylin–eosin 4×. The hematoxylin–eosin stain shows a breast localization (with healthy parenchyma visible in the upper right side) of a poorly differentiated carcinoma with a solid structure composed of epithelial elements with round, vesicular nuclei; small nucleoli; abundant eosinophilic cytoplasm; and a moderate desmoplastic reaction. Numerous mitotic figures are also observed.

Figure 3

All the important examinations are summarized in this timeline.