Mucocele-like lesions (MLL) of the breast are characterized by cystic architecture with stromal mucin and frequent atypia, but it is unknown whether they convey long term breast cancer risk. We evaluated 102MLL that were derived from a single institution benign breast disease (BBD) cohort of 13412 women who underwent biopsy from 1967–2001.MLL were histologically characterized by type of lining epithelium, architecture of the lesion, associated atypical hyperplasia (AH) and for incidence of breast cancer (14.8 years median follow-up). A relatively large proportion of MLL (42%) were diagnosed in women >55 years of age AH was significantly more frequent in MML patient compared to the cohort overall (27% vs 5%, p<0.001). Breast cancer has developed in 13 patients with MLL.. This frequency is only slightly higher than population expected rates overall (Standardized incidence ratio (SIR) 2.28, 95% CI 1.21–3.91), and not significantly different from women in the cohort with (non atypical) proliferative breast lesions. Younger women (<45) with MLL had a non-significant increase in risk of cancer compared to the general population (SIR 5.16, 95% CI 1.41–13.23). We conclude MLL is an uncommon breast lesion that is often associated with co-existing AH. However, in women over age 45, MLL do not convey additional risk of breast cancer beyond that associated with the presence of proliferative disease.
Prostate cancer is the third most leading cause of cancer in men in the United States. Although expected metastatic spread to bone, liver, and lymph nodes are often monitored, there are other rare presentations that can occur. This case report demonstrates a rare presentation of prostate cancer spreading to the paranasal sinuses and orbit. Not only did this case have an atypical presentation mimicking infection, the diagnosis was also only achieved through pathological evaluation after an endoscopic examination and biopsy. This case demonstrates the importance of a low threshold for endoscopic examinations in uncertain sinonasal presentations, and consistent biopsies when performing endoscopic examinations.
The purpose of this manuscript is to report a case of symptomatic breast cancer metastasis to the pituitary gland, a described yet exceedingly rare phenomenon. A 52-year-old woman with a known history of stage-IV breast cancer treated 3 years prior with chemotherapy presented to the emergency department with 2 weeks of right-sided periorbital headache and 1 week of right-sided ptosis. Magnetic resonance imaging showed a 1.9 cm × 2.8 cm × 2.8 cm mass in the pituitary with mass effect on the right optic chiasm. Endocrine laboratory studies were largely normal, including prolactin, thyroid-stimulating hormone, insulin-like growth factor, and a minimally decreased cortisol. She underwent endoscopic transnasal transsphenoidal resection 4 days later to remove the mass without complication. Postoperative pathologic studies were positive for breast cancer metastasis, and she was subsequently started on adjuvant radiation and oral chemotherapy. While breast cancer metastases to the sella have been described in the literature before, symptomatic spread to the pituitary represents a small percentage of all breast cancer metastases, and we thus feel is worthy of further discussion.
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