A case of breast cancer metastatic to the tail of the pancreas

Abstract

Breast cancer metastasis to pancreas is rarely seen. There have been only 6 cases described in the literature. We present the seventh case of a 54-year-old woman with breast cancer that metastasized to the tail of the pancreas 4 years and 4 months after radical mastectomy. Although the serum levels of CA15-3 and TPA had gradually increased without symptoms, it was difficult to establish the diagnosis before contrast-enhanced abdominal CT scan was performed. Immunohistochemical staining using E-cadherin was positive, proving that the breast cancer was ductal rather than lobular in origin. CA15-3 immunohistochemically stained positive in the resected pancreas lesion. Positive monoclonal staining by GCDFP-15 (gross cystic disease fluid protein-15) in the pancreas tumor also confirmed it breast cancer origin. Investigation of chemokine/chemokine receptors may clarify a new mechanism of metastasis to the pancreas from breast cancer.

Choroid as the first recurrence site: 13 years after breast carcinoma

“…Positive CA15-3 tissue staining is thought to be specific to breast cancer. [6] In a review of 264 breast cancer patients, the uvea was the first systemic metastatic site of previously diagnosed breast cancer in 43 (16%) patients. [7] Freedman et al [8] reviewed the charts of 112 patients (141 eyes) presenting with a metastasis to the eye or orbit and revealed that the average time from the breast cancer diagnosis to metastasis to the eye and orbit was approximately 4 years (1266 days).…”

Pancreatic metastases from ductal and lobular carcinomas of the breast

“…Resection should be considered for metastases to the pancreas in the absence of generalised metastatic disease, but surgery may contribute to prolonged survival and offers significant palliation even in extended extrapancreatic disease [8,9]. Endoscopic palliation or chemotherapy alone could be considered too.…”

Metastasis to the Pancreas from Breast Cancer: Difficulties in Diagnosis and Controversies in Treatment

“…Lobular carcinoma was demonstrated in 8 cases, signetring cells in one, comedo type in another and scirrhous type in another of the 11 treated cases. The disease free interval varies from 16 to 84 months (mean 43.3), and the interval of our case was 24 months without any symptoms [2,[4][5][6][7][8][9][10][11].…”

“…In the literature, we found 11 cases of solitary metastases to the pancreas [2,[4][5][6][7][8][9][10][11] and the dissemination to the pancreatic head is more common than to the pancreatic tail. Lobular carcinoma was demonstrated in 8 cases, signetring cells in one, comedo type in another and scirrhous type in another of the 11 treated cases.…”

“…However, lymphatic and haemato geneous dissemination are the most common, notably from carcinoma of the kidney and the lung. Less common are carcinomas from colon, thyroid, breast, skin, oesophagus, stomach, jejunum, gallbladder, bladder, endometrium or ovarium [2].…”