The prognosis of patients with breast cancer symptomatically metastatic to the ovary is almost uniformly poor. In this case report, we present a 33-year-old para-4 with a symptomatic metastasis to the ovary. Previously, a modified radical mastectomy with adjuvant radiotherapy had been performed for invasive ductal carcinoma of the left breast. Laparotomy showed a 13-cm tumor of the left ovary; frozen section histology showed malignancy consistent with the previous breast cancer. The patient received adjuvant combination chemotherapy. About 5 years later, a carcinoma of the right breast was treated with conservative surgery and adjuvant radiation and chemotherapy. After a further 4 years, a recurrence at the left chest wall was treated with radiation. At the last follow-up, more than 13 years after the first breast cancer and 12 years after the ovarian metastasis, the patient was alive and well without evidence of disease. Bilateral oophorectomy is a therapeutic option in premenopausal patients with localized or advanced breast cancer. Our patient experienced long-term disease-free survival following an isolated metastasis to one ovary. This represents the first report of long-term survival of such a patient in the literature.
Abstract.Zehetleitner G, Thiel I, Petru E. Long-term disease-free survival after breast cancer metastatic to the ovary.The prognosis of patients with breast cancer symptomatically metastatic to the ovary is almost uniformly poor. In this case report, we present a 33-year-old para-4 with a symptomatic metastasis to the ovary. Previously, a modified radical mastectomy with adjuvant radiotherapy had been performed for invasive ductal carcinoma of the left breast. Laparotomy showed a 13-cm tumor of the left ovary; frozen section histology showed malignancy consistent with the previous breast cancer. The patient received adjuvant combination chemotherapy. About 5 years later, a carcinoma of the right breast was treated with conservative surgery and adjuvant radiation and chemotherapy. After a further 4 years, a recurrence at the left chest wall was treated with radiation. At the last follow-up, more than 13 years after the first breast cancer and 12 years after the ovarian metastasis, the patient was alive and well without evidence of disease. Bilateral oophorectomy is a therapeutic option in premenopausal patients with localized or advanced breast cancer. Our patient experienced long-term disease-free survival following an isolated metastasis to one ovary. This represents the first report of long-term survival of such a patient in the literature.
Background: Extraosseous osteosarcoma is a rare disease with approximately 150 cases reported in the literature. Primary osteogenic sarcoma of the breast is considered a particularly rare localisation. Approximately 20 cases of osteogenic sarcoma of the breast have been reported in the literature. The radiographic findings of the primary lesion are often misinterpreted as benign fibroadenomas the diagnosis of this rare disease is based on histological criteria. Osteogenic sarcomas of the breast have a high tendency towards local recurrences early haematogenous pread particularly pulmonary metastases. Case Report: Osteogenic sarcoma of the breast was diagnosed in a 48-year-old woman. Following mastectomy axillary lymph node dissection the patient developed liver thoracic wall metastases. She obtained a complete remission to COSS-86 chemotherapy but subsequently relapsed died from disseminated tumour despite repeated surgical attempts postoperative radiotherapy palliative chemotherapy 24 months after the primary diagnosis. Conclusions: Based on the currently available data of the cases reported radical resection of the primary tumour including axillary lymph node dissection is probably the appropriate surgical approach for primary osteogenic sarcoma of the breast. Since chemosensitivity of this malignancy has been observed adjuvant treatment according to the regimens employed for the treatment of osteogenic sarcoma of the bone (COSS treatment protocol) is recommended in order to improve the otherwise poor prognosis of patients with osteogenic sarcoma of the breast.
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