Metastatic Breast Carcinoma With Multiple Osteolytic Lesions - A Diagnostic Dilemma

Abstract

Bone is one of the common sites for distant metastasis from breast cancer. About 6%-10% of breast carcinomas have already spread to distant sites at the time of initial diagnosis. Presence of bone metastasis affects patient's prognosis and the planning of treatment. We report a case of 32year old female who presented with a subtrochanteric fracture left femur and multiple osteolytic lesions throughout the axial skeleton leading to clinical suspicion of multiple myeloma. Hematological work up suggested a metastatic deposit. Subsequent detailed examination revealed a breast lump in right breast. On core biopsy it was diagnosed as duct cell carcinoma. This report addresses the role of bone marrow examination in arriving at a diagnosis in multiple osteolytic lesions which pose wide differential diagnoses.