Successful management of synchronous recurrent breast carcinoma with chronic myelogenous leukemia: a case report

Abstract

BackgroundSurvival is increasing after early breast cancer revealing frequent relapses and possibility of developing secondary malignancies. The concomitant occurrence of these two events is exceptionally disastrous and lethal. We report a case of a Moroccan woman who was successfully managed for synchronous recurrent breast carcinoma and chronic myelogenous leukemia.Case presentationA 42-year-old Moroccan woman was diagnosed with localized breast carcinoma in 2008. She received six cycles of an adjuvant chemotherapy regimen, radiation therapy and hormonal therapy by tamoxifen. After completion of 5 years of tamoxifen our patient reported asthenia; a physical examination found hepatomegaly, massive splenomegaly measuring 21 cm and supraclavicular lymphadenopathy. The staging showed lung and liver metastases. Morphology and immunohistochemical profile of this metastasis identified an adenocarcinoma of mammary origin. In parallel, the diagnosis of chronic myeloid leukemia was suspected because of the presence of a leukocytosis at 355 × 109/L, with circulating blasts of 4%. Chronic myeloid leukemia was confirmed by a bone marrow biopsy with the presence of Ph chromosome on cytogenetical analysis.Daily imatinib was ordered concurrently with chemotherapy-type docetaxel. The metastases were stable after nine courses of chemotherapy. Due to breast cancer progression 4 months later, bevacizumab and capecitabine were introduced.A major molecular response was achieved after 12 and 18 months. She has now completed 2 years of follow-up, still on a major molecular response, and is undergoing imatinib and capecitabine treatment.ConclusionsLeukocytosis in breast cancer patients can reveal chronic myeloid leukemia. It may warrant a workup to find the underlying etiology, which could include a secondary hematological malignancy.

A Case of Chronic Myeloid Leukemia Presenting with Osteoid Osteoma: A Diagnostic Dilemma

“…Secondary primary malignancy of the breast, neuroendocrine tumor of the caecum, squamous cell carcinoma of the skin, acute lymphocytic leukemia have been reported but there has been no case of any benign tumor being reported in the literature [9][10][11]. Elmhadi et al reported a case of successful management of synchronous recurrent breast carcinoma with chronic myelogenous leukemia [12]. Pan L et al reported a case of secondary breast carcinoma after completely remitted chronic myeloid leukemia following targeted tyrosine kinase therapy [13].…”

A Rare Case of Synchronous us Carcinoma Breast with Chronic Myeloid Leukemia

“…The results of randomized clinical trials have suggested that patients with primary breast carcinoma have an increased risk of developing leukemia. But this risk is not well characterized [7,8,9]. Increase in risk is attributable to adjuvant therapy, especially anthracycline and alkylating agent dose intensification, and perhaps to concomitant radiotherapy use.…”