Metastasis to the Male Breast from Gastric Cancer : Differential Diagnosis from Primary Male Breast Cancer Using Histological and Cytological Methods
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概要
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In patients with two or more neoplastic lesions with similar histological features, the differentiation between primary and metastatic lesions is difficult but is essential for the determination of the appropriate treatment. We report a case of an 80-year-old man with metastatic cancer to the breast from gastric cancer without other visceral metastasis. Gastric cancer was identified by gastroendoscopy and a biopsy, and aspiration cytology from a nodular breast lesion revealed a poorly differentiated adenocarcinoma which resembled the gastric cancer. Computed tomography (CT) and magnetic resonance imaging (MRI) showed no other lesions within the body. Our initial diagnosis was double cancer of the male breast and stomach. Total gastrectomy and breast excisional biopsy with resection of the lymph nodes was performed. Histologically, there was necrosis in the center of the breast lesion, and no mammary gland tissue was present near or around the lesion. Immunohistochemical staining revealed the breast lesion was positive for carcinoembryonic antigen (CEA) and negative for the estrogen receptor (ER) and progesterone receptor (PgR), suggesting the cancer was more likely derived from the stomach. Our final diagnosis was metastasis to the breast from gastric cancer. Careful microscopic examination of cytological and histological specimens using immunohistochemical staining technology can aid the differential diagnosis of primary and metastatic carcinomas.
- 昭和大学・昭和医学会の論文
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