Abstract; Breast is an uncommon and rare site for metastasis. Primary and secondary tumors of the breast need to be differentiated as management is different. We present a 67 year old female patient with two breast lumps and an axillary lymph node, 5 years after nephrectomy for Renal Cell Carcinoma (RCC). Mammogram report showed a dense spiculated mass at right upper outer quadrant and a retroareolar mass associated with clustered micro calcifications. Fine Needle Cytology and trucut biopsy were inconclusive. Computer Topography (CT) abdomen did not show evidence of RCC recurrence. After discussion with the patient, she underwent mastectomy with axillary clearance and the final histopathology report was consistent with metastasis from RCC. The management of this case is discussed.Key words: Ext ammammary breast metastasis, Renal cell carcinoma, Post radical nephrectomy. r
IntroductionRenal cell carcinoma, which accounts for approximately 3% of all adult cancers, has a tendency to metastasize, commonly to the lungs, bones, liver, adrenal glands and brain. Metastases to the breast from extramammary tumours are uncommon and metastatic renal cell carcinoma to the breast is extremely rare accounting for 3% of the cases [1]. We report metastases to the breast and the difficulty in diagnosis. Thus far, this is the first case reported as in most cases; the metastasis to the breast is part of systemic metastases.
Presence of a hypofunctioning pigmented adenoma are commonly asymptomatic and is usually only found during an autopsy. In contrast, hyperfunctioning pigmented adenoma is a rare clinical entity and in the majority of cases results in Cushing"s syndrome. In this case study, we report a 66-year-old male who presented instead with the clinical and biochemical features of Conn"s syndrome. On laparoscopic adrenalectomy, it was found that the tumour had a functioning black adenoma which does not usually present with Conn"s syndrome but rather to that of a Cushing"s. The intraoperative changes and histopathological findings are discussed.
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