Fallopian tube metastasis in a patient with a history of breast cancer

Abstract

ÖZMeme kanserinin fallop tüpüne metastazı oldukça nadir görülür. Tedavi ve prognozları farklı olduğundan primer fallop tüpü tümörü ile fallop tüpüne meme kanseri metastazının birbirinden ayırt edilmesi ve durumun cerrahiden önce patolojik olarak doğrulanması zordur. Biz burada 13 yıl önce meme kanseri nedeniyle sol modifiye radikal mastektomi hikayesi olan 46 yaşında bir kadın hastayı sunduk. Hasta sol adneksiyel kitle ile başvurdu. Total abdominal histerektomi ile birlikte bilateral salpingo-ooferektomi yapıldı. Immünhistokimyasal olarak tümör hücreleri sitokeratin 7 (CK7), östrojen reseptörü (ER) ve progesteron reseptörü (PR) ile pozitif boyandı. Mammoglobulin (x2), P53, CK20, GCDFP-15, trombomodulin ve HER2 boyası negatifti. HER2 için floresan in situ hibridizasyon (FISH) negatifti. Hastaya tümörün hem morfolojik hem de immünfenotipik özellikleri nedeniyle meme kanserinin fallop tüpüne metastazı tanısı konulmuştur. Anahtar kelimeler: Fallop tüp kanseri, Meme kanseri, Fallop tüpüne metastaz IntroductionBreast cancer is the most common malignancy in women. Breast cancer usually presents as a localized disease, however, one to five percent of women diagnosed with breast cancer have metastatic disease on presentation. Another 30 percent of women with early-stage breast cancer at diagnosis would develop distant metastatic disease after treatment [1]. Metastatic breast cancer is unlikely to be cured; median survival is approximately 18 to 24 months, though this varies based on subtype of tumor, sites of metastatic involvement, and burden of metastatic disease [2]. The most common metastasic sites are the lung, liver, brain, and bone [3].We report the development of metastasis to the fallopian tube in a 46 year-old woman who had prior history of breast carcinoma. ABSTRACTBreast carcinoma metastasis to the fallopian tube is extremely rare. Distinction between a primary fallopian tumor and metastasis of breast cancer is crucial since treatment and prognosis are different. However, it is difficult to confirm pathologically without surgery. Herein, we report a 46-year-old woman with a history of left modified radical mastectomy for breast cancer 13 years ago, presenting with a left adnexial mass. She underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy. Pathology findings revealed cytokeratin (CK) 7, ER, and PR positive tumor cells. Mammoglobuline, P53, CK20, GCDFP-15 and, thrombomoduline were negative. HER2 was also 2+. Fluorescence in situ hybridization (FISH) for HER2 was negative. Based on the morphology and immunophenotype of the tumor, we established the diagnosis as metastasis of breast cancer to the fallopian tube.