Solitary uterine metastasis of invasive lobular carcinoma after adjuvant endocrine therapy: a case report

Abstract

IntroductionSolitary uterine metastases from extragenital cancers are very rare. Breast cancer is the most frequent primary site of metastasis to the uterine corpus, with invasive lobular carcinoma more likely to spread to gynecologic organs than invasive ductal carcinoma.Case presentationA 62-year-old postmenopausal Japanese woman was diagnosed with uterine leiomyomata more than 20 years ago and had been managed conservatively until menopause. Seven years prior to her presentation, she was diagnosed with breast cancer and underwent a partial resection of her right breast for stage IIA invasive lobular carcinoma. She underwent adjuvant chemotherapy, radiotherapy, and five years of anastrozole hormonal therapy. She presented with a growing uterine mass. Her tumor marker levels were markedly increased over the course of her follow-up, but a systemic examination revealed only a solitary uterine tumor. She underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy. A histopathological examination, including detailed immunohistochemistry, confirmed metastatic invasive lobular carcinoma, infiltrating both her uterine myometrium and fibroid tissue.ConclusionWe report a very rare metastatic pattern of invasive lobular carcinoma and demonstrate that gross cystic disease fluid protein-15 and mammaglobin are useful in the diagnosis of metastatic breast cancer.

Metastases from lung adenocarcinoma within a leiomyoma: A case report

“…A literature search was conducted in PubMed, using the terms “metastasis to fibroid,” “metastasis to leiomyoma,” “cancers metastasize to gynecologic organs,” “cancer metastasis to uterus,” and “extra genital cancer metastases to uterus,” and further references were collected based on works cited by reviewed articles. There were reports of invasive breast cancer (lobular and ductal) ( Toyoshima et al, 2015 ), two cases of stomach and pancreas, gallbladder ( Kumar and Hart, 1982 ), melanoma ( Chanthasenanont et al, 2015 ), a gastric adenocarcinoma metastatic to a lipoleiomyoma, and leiomyosarcoma metastasizing to leiomyomata. The most complete of these works included 63 cases of extragenital metastasis to the uterine corpus, with 13 cases involving leiomyomata, and 6 of those 13 solely involving a metastasis to a leiomyoma ( Kumar and Hart, 1982 ).…”

“…The most complete of these works included 63 cases of extragenital metastasis to the uterine corpus, with 13 cases involving leiomyomata, and 6 of those 13 solely involving a metastasis to a leiomyoma ( Kumar and Hart, 1982 ). Breast cancer was the most commonly found extragenital neoplasm metastasizing to leiomyomata in that review; invasive lobular over ductal breast carcinoma more commonly spread to the gynecologic organs ( Toyoshima et al, 2015 ).…”

“…Common malignant neoplasms that metastasize to the gynecologic tract include colon and breast, with other reports finding gastric cancer metastases, especially in one study set in Japan, where the rate of gastric cancer is much higher overall. In those pelvic masses thought to be primary ovarian cancers, between 5 and 20% of these ultimately are found to be metastases ( Toyoshima et al, 2015 ). Finding occult uterine malignant neoplasms in presumed benign leiomyomata after surgery is uncommon but controversial.…”

An interesting case of uterine tumour: a case report

“…Invasive lobular carcinoma has more tendency to metastasize to uterus when compared to ductal carcinoma. [6][7][8] As the morphology of the tumour cells resembles epitheloid in appearance, these tumours must be differentiated from primary uterine tumours with epitheloid appearance.…”

Unexpected tumor‐to‐tumor metastasis of synovial sarcoma within leiomyoma: A case report and literature review

“…Recently, we experienced a case of a metastatic synovial sarcoma (SS) in a uterine leiomyoma. Although there are several case reports of TTM to uterine leiomyoma, the most common type of donor tumor in the previous reports was found to be carcinoma such as breast cancer and lung cancer, among others 4–29 . There is no report of sarcoma metastasis to a uterine leiomyoma.…”